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1831542190
PHYLLIS THORNTON WAGGONER
GLEN ALLEN, VA
NPI
1831542190
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: VA 0024173765)
Enumeration Date
2016-07-21
Last Update Date
2016-10-06
Business Address
Mrs. PHYLLIS THORNTON WAGGONER NP-C
11271 NUCKOLS RD
GLEN ALLEN, VA 23059-5502
Phone number: 804-217-8881
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Mailing Address
Mrs. PHYLLIS THORNTON WAGGONER NP-C
11271 NUCKOLS RD
GLEN ALLEN, VA 23059-5502
Phone number: 804-217-8881
Copy
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