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NPI Code Detail

MEDICARE: BRIDGET FACENDA WADDELL

MEDICARE: BRIDGET FACENDA WADDELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist6932NC

General Provider Information

NPI Number : 1740119874
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGET FACENDA WADDELL
Provider Business Mailing Address
First Line : 7607 LULLWATER CV
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-6354
Country : US
Telephone Number : 704-578-2808
Fax Number :
Provider Business Practice Location Address
First Line : 6635 EXECUTIVE CIR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28212-3811
Country : US
Telephone Number : 980-343-2728
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2026
Last Update Date : 05/15/2026

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Directions to “ BRIDGET FACENDA WADDELL ” Practice Location

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