AMBER LEIA WAGGONER NP NPI 1083483713

NPI Information

  • NPI: 1083483713
  • Provider Name: AMBER LEIA WAGGONER, NP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2413 MEMORIAL PKWY
    PORTLAND, TX
    ZIP 78374
  • Phone: (361) 643-4546

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NPI Details

Amber Leia Waggoner, NP is a family nurse practitioner in Portland, TX with 2 years of experience. Amber Leia Waggoner, NP NPI is 1083483713. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2413 MEMORIAL PKWY
PORTLAND, TX
ZIP 78374-209
Phone: (361) 643-4546
Fax: (361) 758-2137

The NPI 1083483713 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/21/2023 and was last updated on 1/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamily1145675TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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