Active NPI
Gabrielle Renee Waggoner
- Neonatal Intensive Care Registered Nurse
- Shreveport, LA
National Provider Identifier
1124937479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Intensive Care Registered Nurse
- License
- 201123
- Practice address
- 2510 Bert Kouns Industrial Loop
Shreveport, LA 71118-3180 - Phone
- (318) 707-2429
- NPI assigned
- Sep 3, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Intensive Care Registered Nurse | 163WN0002X | 201123 | LA | Primary |
Addresses
Primary practice location
2510 Bert Kouns Industrial Loop
Shreveport, LA 71118-3180
Mailing address
541 Brunswick GDNS
Haughton, LA 71037-8780
Phone (318) 707-2429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1124937479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 BRUNSWICK GDNS",
"city": "HAUGHTON",
"state": "LA",
"postal_code": "710378780",
"telephone_number": "318-707-2429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2510 BERT KOUNS INDUSTRIAL LOOP",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711183180",
"telephone_number": "318-707-2429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGGONER",
"first_name": "GABRIELLE",
"middle_name": "RENEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-03",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "163WN0002X",
"taxonomy_group": "",
"desc": "Registered Nurse, Neonatal Intensive Care",
"state": "LA",
"license": "201123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.