Wagoner, Traci
Wagoner, Traci is an individual health care provider with primary practice located at 2424 Zumbehl Rd , Saint Charles MO 63301-1131. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wagoner, Traci can be contacted via phone (636) 443-4202.Contact Information
Primary practice address
2424 Zumbehl Rd
Saint Charles MO 63301-1131
Phone: (636) 443-4202
Fax: (636) 277-7386
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 2012033129 | Missouri |
Profile Details
| NPI number | 1568715712 |
|---|---|
| LBN Legal business name | Wagoner, Traci |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 24th, 2012 |
| Last updated | Mar 25th, 2025 - about last year |
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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