Wagoner, Georgine

Wagoner, Georgine is an individual health care provider with primary practice located at 1407 Independence Ave 5Th Floor, Waterloo IA 50703-4300. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Wagoner, Georgine can be contacted via phone (319) 291-2413.

Contact Information

Primary practice address
1407 Independence Ave 5Th Floor Waterloo IA 50703-4300
Phone: (319) 291-2413
Fax: (319) 291-2659
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X C-041395 Iowa

Profile Details

NPI number 1578858999
LBN Legal business name Wagoner, Georgine
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2011
Last updated Jun 14th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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