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1609559244
JACOB DANIEL WADE
SHREVEPORT, LA
NPI
1609559244
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LA2100X Nurse Practitioner Acute Care
(Licence: LA 231241)
Enumeration Date
2023-08-10
Last Update Date
2023-08-10
Business Address
JACOB DANIEL WADE
2600 GREENWOOD RD
SHREVEPORT, LA 71103-3908
Phone number: 318-212-4000
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Mailing Address
JACOB DANIEL WADE
550 DALEY
PRINCETON, LA 71067-9111
Phone number: 318-268-5341
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