NPI 1033003116

Mallori Jane Wagoner

Practitioner Personal Care Attendant Council Bluffs, IA

Practice location

Address: 2724 Avenue B, Council Bluffs, IA 51501-2106
Phone: (402) 679-2834
Mailing address: 21 Indian Hills Rd, Council Bluffs, IA 51503-4843

Registered specialties

Personal Care Attendant Primary

Nursing Service Related Providers Taxonomy 3747P1801X

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Registry record

NPI: 1033003116
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Jun 2025
Record last updated: 4 Jun 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.