Individual
MADELINE TISDALE WADDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3104 BLUE LAKE DR STE 110, VESTAVIA, AL 35243-2372
(205) 977-1949
Mailing address
1512 LINDA VISTA DR, VESTAVIA, AL 35226-3520
(865) 804-6526
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-169544
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
148527
AL
Other
Enumeration date
03/11/2024
Last updated
05/02/2024
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