MEDICARE: AUSTIN CHRISTOPHER WAUGH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	PN5267212	FL

General Provider Information

NPI Number	:	1962342394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUSTIN CHRISTOPHER WAUGH

Provider Business Mailing Address
First Line	:	4435 TOUCHTON RD E APT 1008
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-4466
Country	:	US
Telephone Number	:	904-796-1553
Fax Number	:

Provider Business Practice Location Address
First Line	:	4435 TOUCHTON RD E APT 1008
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32246-4466
Country	:	US
Telephone Number	:	904-796-1553
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2026
Last Update Date	:	03/28/2026

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