Cristina Suzanne Wagoner, REGISTERED NURSE

Primary specialty

Medical-Surgical Registered NurseTaxonomy code 163WM0705X

License

60186 Issued in WV

Practice address

1 Med Center Dr
Clarksburg, WV 26301-4155

Phone

(304) 623-3461

NPI assigned

Aug 18, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1326447194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 GABLES PL",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309246",
            "telephone_number": "304-844-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MED CENTER DR",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263014155",
            "telephone_number": "304-623-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGONER",
        "first_name": "CRISTINA",
        "middle_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "60186",
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "WV",
            "license": "60186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Vincent
• Angelique Ferrer Vitug, MD
• Tekisha Dehaven Waddell
• Kimberly Sue Waggy, MA;EDS
• Angela D Wagner, LICSW
• Ruth Wagoner
• Elizabeth Lague Wakim, D.D.S.
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP.
• Kurt J Walck, PHARM.D.

• Medical-Surgical Registered Nurse in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• Medical-Surgical Registered Nurse in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.