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Organization
WADDELL CLINIC PRIMARY CARE & AESTHETICS PLLC
Active
Organization
WADDELL CLINIC PRIMARY CARE & AESTHETICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA WADDELL NP-C (OWNER)
(731) 415-8277
Entity
Organization
Contact information
Practice address
9785 HWY 79 S, HENRY, TN 38231
(731) 423-1450
(731) 423-1000
Mailing address
9785 HIGHWAY 79 S, HENRY, TN 38231-3613
(731) 243-1450
(731) 243-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/03/2023
Last updated
05/31/2024
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