Organization · Type 2 NPI
Wagoner Primary Care, LLC
Family Nurse Practitioner · Evening Shade, AR
NPI number
1811578701
Active
Practice location
1477 Highway 167
Evening Shade, AR 72532-9497
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
Another provider at this address
About NPI 1811578701
Wagoner Primary Care, LLC's National Provider Identifier is 1811578701, issued on Apr 21, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Evening Shade, AR. The record was last updated on Apr 21, 2021.