Individual
MRS. KIEONNA WADLINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-C
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(623) 533-1495
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(623) 533-1495
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
225445
AZ
363LG0600X
Gerontology Nurse Practitioner
27568
TN
363LG0600X
Gerontology Nurse Practitioner
Primary
3014638
KY
Other
Enumeration date
05/29/2019
Last updated
11/01/2020
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