NPI | 1396045506 |
---|---|
Former Name | DUSTY R WADE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX ap119444) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX ap119444) |
363LC1500X Nurse Practitioner, Community Health (Licence: TX ap119444) | |
363LF0000X Nurse Practitioner, Family (Licence: TX 680616) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: TX ap119444) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: TX ap119444) | |
Enumeration Date | 2010-10-22 |
Last Update Date | 2019-03-25 |