Provider Demographics
NPI:1871969881
Name:WALDRUP, DEIRDRE MICHELLE (APRN)
Entity type:Individual
Prefix:MRS
First Name:DEIRDRE
Middle Name:MICHELLE
Last Name:WALDRUP
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:3901 RAINBOW BLVD. 4070 DELP, MS 4017
Mailing Address - Street 2:KANSAS UNIVERSITY PHYSICIANS, INC.
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-0001
Mailing Address - Country:US
Mailing Address - Phone:913-588-2501
Mailing Address - Fax:913-588-3877
Practice Address - Street 1:3901 RAINBOW BLVD. 6040 DELP, MS 1020
Practice Address - Street 2:DIVISION OF GENERAL AND GERIATRIC MEDICINE, UNIVERSITY
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-6005
Practice Address - Fax:913-588-3877
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS13-93967-072163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse