Individual
EMANUEL MONTEZ WADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 RAILROAD AVE, WAKEFIELD, VA 23888-0097
(757) 312-8730
(757) 510-9326
Mailing address
109 RAILROAD AVE, WAKEFIELD, VA 23888
(757) 312-8730
(757) 510-9326
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
790297
TX
363LF0000X
Family Nurse Practitioner
Primary
0024191239
VA
363LF0000X
Family Nurse Practitioner
AP138266
TX
Other
Enumeration date
07/19/2016
Last updated
05/22/2025
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