Provider Demographics
NPI:1871242636
Name:WADDELL, BRITTANEE
Entity Type:Individual
Prefix:
First Name:BRITTANEE
Middle Name:
Last Name:WADDELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 RIDGEMONT DR APT 1928
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-2779
Mailing Address - Country:US
Mailing Address - Phone:972-322-7367
Mailing Address - Fax:
Practice Address - Street 1:4450 RIDGEMONT DR APT 1928
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-2779
Practice Address - Country:US
Practice Address - Phone:972-322-7367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer