Provider Demographics
NPI:1790801637
Name:WARDELL, LINDA J (APRN)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:J
Last Name:WARDELL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:J
Other - Last Name:DODDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8200 DODGE ST
Mailing Address - Street 2:CHILDREN'S HOSPITAL
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4113
Mailing Address - Country:US
Mailing Address - Phone:402-955-5400
Mailing Address - Fax:
Practice Address - Street 1:8200 DODGE ST
Practice Address - Street 2:CHILDREN'S HOSPITAL - EMERGENCY DEPARTMENT
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4113
Practice Address - Country:US
Practice Address - Phone:402-955-5150
Practice Address - Fax:402-955-5151
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE38667OtherBCBS