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 |