Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 57135 | MN |
Y | 2080P0205X | Pediatric Endocrinologist | 33683 | NE |
NPI | 1306086137 |
---|---|
Provider Name | Ms. Heather Diane Wadams |
First Address | Omaha, NE 68114-3567 |
Second Address | Omaha, NE 68114-3567 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2009 |
Last Update Date | 07/10/2021 |