Healthcare Provider Details

I. General information

NPI: 1881760163
Provider Name (Legal Business Name): BARBARA WAEDEKIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. BARBARA JEAN SAPIENZA

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 WEST COLLEGE AVE SUITE 300
APPLETON WI
54914
US

IV. Provider business mailing address

4351 WEST COLLEGE AVE SUITE 300
APPLETON WI
54914
US

V. Phone/Fax

Practice location:
  • Phone: 920-843-5660
  • Fax: 920-843-5685
Mailing address:
  • Phone: 920-843-5658
  • Fax: 920-843-5685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number36810-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: