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Individual

NICOLE WADDLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
7480 HALCYON POINTE DR STE 300, MONTGOMERY, AL 36117-8111
(334) 218-4339
Mailing address
1212 KINGSTON GREEN DR, PRATTVILLE, AL 36067-1728
(334) 315-7015

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-164871
AL
363LA2200X
Adult Health Nurse Practitioner
1-164871
AL

Other

Enumeration date
01/09/2023
Last updated
06/07/2024
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