| NPI | 1275112468 |
|---|---|
| Professional Name | ALISSA WADDELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR 214732) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1021396) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2021-04-05 |