Provider Demographics
NPI:1477716660
Name:WADDELL, DANNY W (ARNP)
Entity Type:Individual
Prefix:
First Name:DANNY
Middle Name:W
Last Name:WADDELL
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 CUMBERLAND FALLS HWY
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-2714
Mailing Address - Country:US
Mailing Address - Phone:606-528-0305
Mailing Address - Fax:606-523-4368
Practice Address - Street 1:1007 CUMBERLAND FALLS HWY
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2714
Practice Address - Country:US
Practice Address - Phone:606-528-0305
Practice Address - Fax:606-523-4368
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY46126363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner