Individual
ANNA WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3450 N ROCK RD STE 503, WICHITA, KS 67226-1355
(316) 312-0002
(316) 854-5644
Mailing address
2402 N VINEGATE CIR, WICHITA, KS 67226-3652
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
78178
KS
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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