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General NPI Number Information
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NPI Number | 1881755528
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Entity Type | Individual
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Provider Name | KATHRYN R. WAITMAN DNP
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Gender | Female
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 269 S CANDY LN
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4158
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Country | US
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Telephone | 928-204-4170
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 N BEAVER ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3118
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Country | US
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Telephone | 928-213-6235
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Fax | 928-213-6292
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | RN130067
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 100236
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9170
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NUR-RN-LIC-21546
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License Number State | MT
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Taxonomy #5
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP2032
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License Number State | AZ
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