Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stacey Alethea Waggoner, APRN-CNP

Individual provider Family Nurse Practitioner · NPI 1285008227

Stacey Alethea Waggoner, APRN-CNP is a Nurse Practitioner in Oklahoma City, Oklahoma. Qualified in 2015, 11 years ago. Practices with Holloway Group Inc, a 7-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
11
Licensed in
OK
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

6613 N Meridian Ave
Oklahoma City, OK 73116-1423
Phone: (405) 603-8450
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 0083425 (OK)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 83425 (OK)

Record details

NPI number1285008227
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN-CNP
Sole proprietorNo
NPI enumeratedNovember 13, 2015
Last updated in NPPESJanuary 9, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Holloway Group Inc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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