| NPI | 1013339142 |
|---|---|
| Former Name | COURTNEY WADE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 794421) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 794421) |
| Enumeration Date | 2014-01-08 |
| Last Update Date | 2021-04-02 |