TRACI WAGONER NPI 1568715712

NPI Information

  • NPI: 1568715712
  • Provider Name: TRACI WAGONER
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 2424 ZUMBEHL RD
    SAINT CHARLES, MO
    ZIP 63301
  • Phone: (636) 443-4202

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NPI Details

Traci Wagoner is a family nurse practitioner in Saint Charles, MO. Traci Wagoner NPI is 1568715712. 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:

2424 ZUMBEHL RD
SAINT CHARLES, MO
ZIP 63301-131
Phone: (636) 443-4202
Fax: (636) 277-7386

The enumeration date for this NPI number is 10/24/2012 and was last updated on 3/25/2025.

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 PractitionerFamily2012033129MISSOURIYes

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: 11/21/2025

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