Individual
MRS. BANDY WAHLSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
25211 S 68TH ST, FIRTH, NE 68358-7598
(402) 791-0040
Mailing address
29151 N GOLDEN POND, FIRTH, NE 68358-6073
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
58758
NE
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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