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MR. CLARENCE HUGHES WAGONER JR. CRNA
NPI 1235126400
Nurse Anesthetist, Certified Registered in Kenansville, NC

Active since October 04, 2005
401 N. MAIN ST., KENANSVILLE, NC 28349(910) 296-2608(910) 296-1174 Get Directions Write a Review

NPPES record last updated: August 24, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mr. Clarence Hughes Wagoner Jr. Crna NPPES

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

MR. CLARENCE HUGHES WAGONER JR. CRNA (NPI 1235126400) is an individual nurse anesthetist, certified registered in Kenansville, North Carolina, licensed in North Carolina (059528) and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1235126400
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameMR. CLARENCE HUGHES WAGONER JR.Credential: CRNA
Location Address401 N. MAIN ST.Kenansville, NC 28349-0278
Mailing AddressPo Box 278Kenansville, NC 28349-0278 · (910) 296-2608 · Fax (910) 296-1174
Phone(910) 296-2608
Fax(910) 296-1174
Sole ProprietorNo
Enumeration DateOctober 4, 2005
Last NPPES UpdateAugust 24, 2009
✔ NPI 1235126400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in NC · 059528
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
401 N. MAIN ST., Kenansville, NC 28349
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Other Identifiers 2

Medicaid8051164NC
Medicare ID-Type Unspecified2616579ANC · Medicare Billing #

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DUPLIN GENERAL HOSPITAL INCORPORATED
General Acute Care Hospital
401 N. MAIN ST.
KENANSVILLE, NC 28349
Duplin County (910) 296-2608
DUPLIN GENERAL HOSPITAL INCORPORATED
General Acute Care Hospital
401 N. MAIN ST.
KENANSVILL, NC 28349
Duplin County (910) 296-2608

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 Clarence Wagoner's NPI number?

The NPI number for Clarence Wagoner is 1235126400. It was assigned to this individual provider in the NPPES registry on October 4, 2005.

Where is Clarence Wagoner located?

Clarence Wagoner practices at 401 N. Main St., Kenansville, NC 28349. The listed phone number is (910) 296-2608.

What is Clarence Wagoner's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

When was this NPI record last updated?

The NPPES record for Clarence Wagoner was last updated on August 24, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years 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.