Provider Demographics
NPI:1851260103
Name:WALDMAN, AUTUMN (RN)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:
Last Name:WALDMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:WAHOO
Mailing Address - State:NE
Mailing Address - Zip Code:68066-1727
Mailing Address - Country:US
Mailing Address - Phone:402-443-4191
Mailing Address - Fax:402-443-1432
Practice Address - Street 1:1760 COUNTY ROAD J
Practice Address - Street 2:
Practice Address - City:WAHOO
Practice Address - State:NE
Practice Address - Zip Code:68066-4152
Practice Address - Country:US
Practice Address - Phone:402-443-4191
Practice Address - Fax:402-443-1432
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE72751163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse