Provider Demographics
NPI:1538882170
Name:WATERFIELD, DENISE (PHD, APRN)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:WATERFIELD
Suffix:
Gender:F
Credentials:PHD, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 W 18TH ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-5944
Mailing Address - Country:US
Mailing Address - Phone:308-251-1913
Mailing Address - Fax:308-224-3241
Practice Address - Street 1:218 W 18TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-5944
Practice Address - Country:US
Practice Address - Phone:308-251-1913
Practice Address - Fax:308-224-3241
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE79843163W00000X
NE114443363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse