Individual
ALICIA ANNE VANDEWALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
106 E WAYNE ST, RANDOLPH, NE 68771-5300
(402) 337-0200
Mailing address
PO BOX 429, 402 N MAPLE, OSMOND, NE 68765-0429
(402) 748-3393
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
112022
NE
Other
Enumeration date
06/13/2016
Last updated
08/19/2022
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