National Provider Identifier Database

GEORGINE WAGONER, ARNP – NPI #1578858999
Pediatrics


Contact Information

GEORGINE WAGONER, ARNP
1407 INDEPENDENCE AVE
5TH FLOOR
WATERLOO, IA50703-4300
Phone: 319-291-2413
Fax: 319-291-2659
Website:
Specialty Taxonomy Code
* Pediatrics 363LP0200X

* Indicates primary specialty

NPI Profile & details for GEORGINE WAGONER

NPI Number 1578858999
Credentials ARNP (Advanced Registered Nurse Practitioner)
Entity Individual
Enumeration date 06/14/2011
Last updated 06/14/2011 - About 15 years ago
Sole proprietor1 No
Identifiers
  • IA License #: C-041395
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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