NPI | 1629586375 |
---|---|
Doing Business As | WADE FAMILY MEDICINE |
Entity Type | Organization |
Authorized Contact | MODEANNA LEIGH WADE Fnp 901-244-4648 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
261QP2300X Clinic/Center, Primary Care (Licence: TN 16204) | |
261QR1300X Clinic/Center, Rural Health (Licence: TN 16204) | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2018-01-16 |
Last Update Date | 2024-07-09 |