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General NPI Number Information
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NPI Number | 1710874995
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Entity Type | Individual
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Provider Name | CORRINE R WADDELL
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Gender | Female
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 2222 S 16TH ST TOWER B STE 405
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City | LINCOLN
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State | NE
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Zip | 68502-3793
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Country | US
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Telephone | 402-481-5860
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 860876
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City | MINNEAPOLIS
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State | MN
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Zip | 55486-0876
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Country | US
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Telephone | 402-483-8590
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Fax | 402-483-8599
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 115981
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License Number State | NE
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