Amanda Mitchell Waggoner, PAC

Physician Assistant · Williamsburg, VA

Individual Active NPI

NPI number 1477634582

Practice location

207 Bulifants Blvd Ste C
Williamsburg, VA 23188-5732
Phone
(757) 622-6315
Fax
(757) 622-7022

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NPI record

NPI
1477634582
Entity type
Individual (Type 1)
Enumeration date
October 17, 2006
Last updated
June 24, 2024
Certified
June 24, 2024
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 0110002368 VA

Mailing address

6160 Kempsville Cir
Suite 200 a
Norfolk, VA 23502-3933
Phone
(757) 622-6315
Fax
(757) 625-6940

Other practice locations (1)

  • 11842 Rock Landing Dr Ste 120, Newport News, VA 23606-4437 · (757) 595-8816

About Amanda Waggoner

Amanda Mitchell Waggoner, PAC is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 207 Bulifants Blvd Ste C, Williamsburg, VA 23188-5732. The NPI number 1477634582 was assigned on October 17, 2006 and the record was last updated on June 24, 2024.

Amanda Waggoner lists a license in the registry: #0110002368 (VA) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Amanda Mitchell Waggoner, PAC?

The NPI number is 1477634582.

What is the phone number of Amanda Waggoner?

The phone number listed for the practice location is (757) 622-6315.

Where is Amanda Waggoner located?

207 Bulifants Blvd Ste C, Williamsburg, VA 23188-5732.

What is the taxonomy code for Amanda Waggoner?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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