| 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 |