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

Dr. Jae Waggoner, PHARMD

Individual provider Pharmacist · NPI 1932750411

Dr. Jae Waggoner, PHARMD is a Pharmacist in Bossier City, Louisiana. Licensed in Louisiana. Registered with an NPI since 2019.

Licensed in
LA
In the registry since
2019
What do these letters mean?
PHARMD — Doctor of Pharmacy
The professional degree required to practise as a pharmacist in the United States.

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Practice location Address checks out

2107 Airline Dr
Bossier City, LA 71111-3105
Phone: (318) 742-5590
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence PST.023190 (LA)

Record details

NPI number1932750411
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHARMD
Sole proprietorNo
NPI enumeratedSeptember 25, 2019
Last updated in NPPESApril 19, 2023
Certification dateApril 19, 2023

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