NPI | 1205616877 |
---|---|
Former Name | REBECCA M WADE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IN 71014362A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71014362A) |
Enumeration Date | 2023-10-02 |
Last Update Date | 2023-10-09 |