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MISS MALLORI JANE WAGONER
NPI 1033003116
Technician - Personal Care Attendant in Council Bluffs, IA

Active since June 04, 2025
2724 AVENUE B, COUNCIL BLUFFS, IA 51501(402) 679-2834 Get Directions Write a Review

NPPES record last updated: June 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Miss Mallori Jane Wagoner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS MALLORI JANE WAGONER (NPI 1033003116) is an individual personal care attendant in Council Bluffs, Iowa and active in the NPI registry since June 2025.

NPPES Registry Identity

NPI1033003116
Entity TypeIndividualFemale
Primary Taxonomy3747P1801X
Provider Legal NameMISS MALLORI JANE WAGONER
Location Address2724 AVENUE BCouncil Bluffs, IA 51501-2106
Mailing Address21 Indian Hills RdCouncil Bluffs, IA 51503-4843 · (402) 679-2834
Phone(402) 679-2834
Sole ProprietorYes
Enumeration DateJune 4, 2025
NPPES CertifiedJune 4, 2025
✔ NPI 1033003116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyTechnician · Personal Care AttendantNursing Service Related Providers
Taxonomy Code3747P1801X
Definition
An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards
2724 AVENUE B, Council Bluffs, IA 51501
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mallori Wagoner's NPI number?

The NPI number for Mallori Wagoner is 1033003116. It was assigned to this individual provider in the NPPES registry on June 4, 2025.

Where is Mallori Wagoner located?

Mallori Wagoner practices at 2724 Avenue B, Council Bluffs, IA 51501. The listed phone number is (402) 679-2834.

What is Mallori Wagoner's specialty?

The primary specialty registered for this NPI is Technician, specializing in Personal Care Attendant, with taxonomy code 3747P1801X.

When was this NPI record last updated?

The NPPES record for Mallori Wagoner was last updated on June 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.