Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wagoner Primary Care, LLC

Organization Family Nurse Practitioner · NPI 1811578701

Wagoner Primary Care, LLC is a Family Nurse Practitioner in Evening Shade, Arkansas. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1477 Highway 167
Evening Shade, AR 72532-9497
Phone: (870) 283-2554
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1811578701
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephanie Wagoner — President · (870) 283-2554
NPI enumeratedApril 21, 2021
Last updated in NPPESApril 21, 2021
Certification dateApril 21, 2021
Mailing address1477 Highway 167, Evening Shade, AR 72532-9497

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