Keith William Wagoner, BSN, RN-BC is a
Registered Nurse - Gerontology based in Kemp, Texas. Keith William Wagoner is licensed to practice in Texas (license number 919371) and his current practice location is
110 N State Highway 274, Kemp, Texas. He can be reached at his office (for appointments etc.) via phone at
(430) 255-2199.
NPI number for Keith William Wagoner is 1407673593 and his current mailing address is 105 Arapaho Trl, Mabank, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1407673593.
Provider's Profile
Full Name | Keith William Wagoner |
---|
Gender | Male |
---|
Speciality | Registered Nurse - Gerontology |
---|
Location | 110 N State Highway 274, Kemp, Texas |
---|
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1407673593
- Provider Enumeration Date: 09/20/2024
- Last Update Date: 09/20/2024
Medical Identifiers
Medical identifiers for Keith William Wagoner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407673593 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163WG0600X | Registered Nurse - Gerontology | 919371 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Keith William Wagoner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Keith William Wagoner, BSN, RN-BC 105 Arapaho Trl, Mabank, TX 75156-9176 Ph: (903) 603-3979 | Keith William Wagoner, BSN, RN-BC 110 N State Highway 274, Kemp, TX 75143-4617 Ph: (430) 255-2199 |
Reviews and Comments