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Mrs. Phyllis Thornton Waggoner, NP-C
Family Nurse Practitioner in Glen Allen, Virginia
NPI 1831542190

Phyllis Thornton Waggoner is a Family Nurse Practitioner based in Glen Allen, VA and is specialized in Family. Phyllis Thornton Waggoner practices in Glen Allen, VA and has the professional credentials of NP-C. The NPI Number for Phyllis Thornton Waggoner is 1831542190 and holds a License No. 0024173765 (Virginia).

The current practice location address for Phyllis Thornton Waggoner is 11271 Nuckols Rd, Glen Allen, VA and can be reached out via phone at 804-217-8881.

Location: 11271 Nuckols Rd, Glen Allen, VA, 23059-5502
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1831542190
Provider Name
Phyllis Thornton Waggoner
Credential
NP-C
Provider Entity Type
Individual
Gender
Female
Address
11271 Nuckols Rd, Glen Allen, VA, 23059-5502
Phone Number
804-217-8881
Fax Number
Provider Enumeration Date
07/21/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
11271 Nuckols Rd
City
Glen Allen
State
Virginia
Zip
23059-5502
Phone Number
804-217-8881
Fax Number
person
Provider Business Mailing Address Details
Address
11271 Nuckols Rd
City
Glen Allen
State
Virginia
Zip
23059-5502
Phone Number
804-217-8881
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
0024173765 (Virginia)
Definition
Definition to come...
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