Dr. Kelley Childress Wagoner
Pharmacist
708 Highway 70 East, Otway, Beaufort
North Carolina, 28516-7273
252-838-1540 252-838-1545
Dr. Kelley Childress Wagoner is a pharmacist in Beaufort, North Carolina. Patients can reach her at 708 Highway 70 East, Otway, Beaufort or contact her on 252-838-1540. Active license number of Dr. Kelley Childress Wagoner is 13866 for Pharmacist in North Carolina.
Dr. Kelley Childress Wagoner is 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.
Complete Profile:
Dr. Kelley Childress Wagoner speciality, credentials, practice address, contact phone number and fax are as below. Patients can call on the below given phone number for enquiries.
| Name: | Dr. Kelley Childress Wagoner |
| Specialization: | Pharmacist |
| Credentials: | PHARM.D., R.PH. |
| Gender: | Female |
| Location: | 708 Highway 70 East, Otway, Beaufort,
North Carolina, 28516-7273 |
| Phone: | 252-838-1540 |
| Fax: | 252-838-1545 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of Dr. Kelley Childress Wagoner are as mentioned below.
| NPI Number: | 1568799039 |
| NPI Enumeration Date: | 04 Nov, 2009 |
| NPI Last Update On: | 07 Mar, 2014 |
Medical Licenses:
Pharmacists can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Kelley Childress Wagoner are as mentioned below.
| Specialization | License Number | State | Status | |
| Pharmacist | 13866 | North Carolina | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Dr. Kelley Childress Wagoner such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 0165515 | Medicaid | North Carolina | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 708 Highway 70 East Otway,
Beaufort, North Carolina |
| Zip: | 28516 |
| Phone Number: | 252-838-1540 |
| Fax Number: | 252-838-1545 |
Patients can reach Dr. Kelley Childress Wagoner at
708 Highway 70 East, Otway, Beaufort, North Carolina or can
call on phone at 252-838-1540.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.