IndividualActive
Shaunda Waddle, CSFA
NPI 1366101784 · Surgical Physician Assistant · Cheyenne, WY
Provider details
- NPI number
- 1366101784
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CSFA
- Sex
- Female
- Sole proprietor
- Yes
- License
- 206758 (WY)
Mailing address
5001 Opal Dr
Cheyenne, WY 82009-5693
Registry dates
- Enumerated
- 2021-12-13
- Last updated
- 2022-01-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.