Healthcare Provider Details

I. General information

NPI: 1003757956
Provider Name (Legal Business Name): CONNIE ANN WALDRON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 N 1ST ST # 23
DONIPHAN NE
68832-9675
US

IV. Provider business mailing address

318 N 1ST ST # 23
DONIPHAN NE
68832-9675
US

V. Phone/Fax

Practice location:
  • Phone: 402-469-8906
  • Fax:
Mailing address:
  • Phone: 402-469-8906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: