| NPI | 1487639019 |
|---|---|
| Former Name | KRISTA K. WADE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R767181) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 767181) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2020-08-11 |