TARA LISA WAGGONER

JONESBORO, AR
NPI1568515930
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: AR  A01852)
Enumeration Date2007-01-19
Last Update Date2007-07-08
Business Address
-- TARA LISA WAGGONER FNP, APN-BC
333 STADIUM BLVD. SUITE B
JONESBORO, AR 72401
Phone number: 870-972-2054
Mailing Address
-- TARA LISA WAGGONER FNP, APN-BC
4203 SANDSTONE DR
JONESBORO, AR 72401-7833
Phone number: 870-910-0436
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