person
Kelsey Anna Wagoner, FNP
Family Nurse Practitioner in Plymouth, Indiana
NPI 1144941758

Kelsey Anna Wagoner is a Family Nurse Practitioner based in South Bend, IN and is specialized in Family. Kelsey Anna Wagoner practices in Plymouth, IN and has the professional credentials of FNP. The NPI Number for Kelsey Anna Wagoner is 1144941758 and holds a License No. 71013346A (Indiana).

The current practice location address for Kelsey Anna Wagoner is 209 E Jefferson St, Plymouth, IN and can be reached out via phone at 574-948-5100 and via fax at 574-335-0745.

Location: 209 E Jefferson St, Plymouth, IN, 46617-2059
person
Provider Profile Details
NPI Number
1144941758
Provider Name
Kelsey Anna Wagoner
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
209 E Jefferson St, Plymouth, IN, 46617-2059
Phone Number
574-948-5100
Fax Number
574-335-0745
Provider Enumeration Date
09/12/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1102690702 01 IN ANTHEM
300070012 05 IN
institution
Provider Business Practice Location Address Details
Address
209 E Jefferson St
City
State
Zip
46563-1861
Phone Number
574-948-5100
Fax Number
574-335-0745
person
Provider Business Mailing Address Details
Address
209 E Jefferson St
City
State
Zip
46563-1861
Phone Number
574-948-5100
Fax Number
574-335-0745
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
71013346A (Indiana)
Definition
Definition to come...
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