IndividualActive
Jacquelin Waggoner, DNP
NPI 1255159935 · Neonatal Nurse Practitioner · Indianapolis, IN
Provider details
- NPI number
- 1255159935
- Entity type
- Individual
- Primary specialty
- Neonatal Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- DNP
- Sex
- Female
- Sole proprietor
- No
- License
- 28230172A (IN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Phone: (317) 274-4779
Fax: (317) 948-9806
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 778912
Chicago, IL 60677-8912
Registry dates
- Enumerated
- 2024-10-01
- Last updated
- 2024-11-04
- Certified
- 2024-11-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.