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Blair Wagoner
Psychiatric/Mental Health Nurse Practitioner in Richmond, Indiana
NPI 1366220907

Blair Wagoner is a Psychiatric/Mental Health Nurse Practitioner based in Muncie, IN and is specialized in Psychiatric/Mental Health. Blair Wagoner practices in Richmond, IN. The NPI Number for Blair Wagoner is 1366220907 and holds a License No. 71014313A (Indiana).

The current practice location address for Blair Wagoner is 501 1/2 S 7Th St., Rm 1, Richmond, IN and can be reached out via phone at 765-935-5390.

Location: 501 1/2 S 7Th St., Rm 1, Richmond, IN, 47304-3988
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366220907
Provider Name
Blair Wagoner
Credential
Provider Entity Type
Individual
Gender
Female
Address
501 1/2 S 7Th St., Rm 1, Richmond, IN, 47304-3988
Phone Number
765-935-5390
Fax Number
Provider Enumeration Date
09/15/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
501 1/2 S 7Th St., Rm 1
City
Richmond
State
Indiana
Zip
47374
Phone Number
765-935-5390
Fax Number
person
Provider Business Mailing Address Details
Address
501 1/2 S 7Th St., Rm 1
City
Richmond
State
Indiana
Zip
47374
Phone Number
765-935-5390
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
71014313A (Indiana)
Definition
Definition to come...
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