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General NPI Number Information
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NPI Number | 1043311632
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Entity Type | Individual
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Provider Name | KARLEE CRUMPTON WAGONER APRN-BC
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 06/11/2015
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Provider Practice Location Address
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Address Line | 5821 FARRINGTON RD SUITE 101
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City | CHAPEL HILL
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State | NC
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Zip | 27517-9901
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Country | US
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Telephone | 919-403-6200
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Fax | 919-403-6242
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Provider Business Mailing Address
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Address Line | 5821 FARRINGTON RD SUITE 101
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City | CHAPEL HILL
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State | NC
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Zip | 27517-9901
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Country | US
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Telephone | 919-403-6200
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Fax | 919-403-6242
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 005001621
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License Number State | NC
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