DR. JAE WAGGONER PHARMD
NPI 1932750411
Pharmacist in Bossier City, LA

Active since September 25, 2019
2107 AIRLINE DR, BOSSIER CITY, LA 71111(318) 742-5590 Get Directions Write a Review

NPPES record last updated: April 19, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jae Waggoner Pharmd NPPES

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

DR. JAE WAGGONER PHARMD (NPI 1932750411) is an individual pharmacist in Bossier City, Louisiana, licensed in Louisiana (PST.023190) and active in the NPI registry since September 2019.

NPPES Registry Identity

NPI1932750411
Entity TypeIndividualFemale
Primary Taxonomy183500000X
Provider Legal NameDR. JAE WAGGONERCredential: PHARMD
Location Address2107 AIRLINE DRBossier City, LA 71111-3105
Mailing Address320 Preserve BlvdBossier City, LA 71112-2081
Sole ProprietorNo
Enumeration DateSeptember 25, 2019
Last NPPES UpdateApril 19, 2023
NPPES CertifiedApril 19, 2023
NPI 1932750411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in LA · PST.023190
Definition
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
2107 AIRLINE DR, Bossier City, LA 71111

Other Providers at the Same Location NPPES 11

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

Pharmacist
2107 AIRLINE DR
BOSSIER CITY, LA 71111
Pharmacist
2107 AIRLINE DR
BOSSIER CITY, LA 71111
Pharmacist
2107 AIRLINE DR
BOSSIER CITY, LA 71111
Pharmacist
2107 AIRLINE DR
BOSSIER CITY, LA 71111
Pharmacist
2107 AIRLINE DR
BOSSIER CITY, LA 71111
Pharmacist
2107 AIRLINE DR
BOSSIER CITY, LA 71111
Pharmacist
2107 AIRLINE DR
BOSSIER CITY, LA 71111
Pharmacy
2107 AIRLINE DR
BOSSIER CITY, LA 71111

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 Jae Waggoner's NPI number?

The NPI number for Jae Waggoner is 1932750411. It was assigned to this individual provider in the NPPES registry on September 25, 2019.

Where is Jae Waggoner located?

Jae Waggoner practices at 2107 Airline Dr, Bossier City, LA 71111. The listed phone number is (318) 742-5590.

What is Jae Waggoner's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Jae Waggoner was last updated on April 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.