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General NPI Number Information
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NPI Number | 1972470623
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Entity Type | Individual
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Provider Name | KATHLEEN WALDRON
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Gender | Female
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Dates
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Enumeration Date | 10/18/2025
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Last Update Date | 10/18/2025
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Provider Practice Location Address
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Address Line | 8303 DODGE ST
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City | OMAHA
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State | NE
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Zip | 68114-4108
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Country | US
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Telephone | 402-391-4855
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Fax |
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Provider Business Mailing Address
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Address Line | 7801 WAKELEY PLZ
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City | OMAHA
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State | NE
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Zip | 68114-3651
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Country | US
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Telephone | 402-391-4855
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Fax | 402-391-6818
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 84712
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License Number State | NE
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