Provider Demographics
NPI:1770933418
Name:WAUGAMAN, COURTNEY (FNP-C)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:WAUGAMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 FAYETTEVILLE ROAD DURHAM
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713
Mailing Address - Country:US
Mailing Address - Phone:919-525-3754
Mailing Address - Fax:919-572-2010
Practice Address - Street 1:6020 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-9754
Practice Address - Country:US
Practice Address - Phone:919-525-3754
Practice Address - Fax:919-572-2010
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008591363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily