| Doctor Name: | RENEE COLLETTE WAGGONER |
| NPI Number: | 1407962293 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS RD LD |
| License Number: | KY-0158 |
| Business Practice Address: | 1530 Lone Oak Rd Paducah, KY - 420037901 |
| Business Phone Number: | 2704442909 |
| Business Fax Number: | 2704442977 |
| Mailing Address: | 1530 Lone Oak Rd, Po Box 7100 PADUCAH |
| State: | KY |
| Postal Code: | 420037901 |
| Phone Number: | 2704442909 |
| Fax Number: | 2704442977 |
| NPI Enumeration Date: | 08/22/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | KY-0158 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |