| NPI | 1609387174 |
|---|---|
| Former Name | LACY WADE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: FL ARNP9429348) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: FL ARNP9429348) |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2018-01-30 |