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

Shy L Wagoner, CST

Individual provider Surgical Technologist · NPI 1164655452

Shy L Wagoner, CST is a Surgical Technologist in Springfield, Illinois. Practices as a sole proprietor. Registered with an NPI since 2009.

In the registry since
2009

Practice location Address checks out

2921 Montvale Dr
Springfield, IL 62704-5359
Phone: (217) 787-2700
Fax: (217) 787-2715
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Technologist (primary) Taxonomy 246ZS0410X

Record details

NPI number1164655452
Entity typeIndividual (Type 1)
GenderFemale
Credentials CST
Sole proprietorYes
NPI enumeratedSeptember 2, 2009
Last updated in NPPESFebruary 17, 2012
Mailing address2921 Montvale Dr, Springfield, IL 62704-5359

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