=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194696401
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMADES WOUND CARE PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2025
-----------------------------------------------------
Last Update Date | 09/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14 HOLLY HILL LN
-----------------------------------------------------
City | PORTSMOUTH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23702-2300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-549-9310
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14 HOLLY HILL LN
-----------------------------------------------------
City | PORTSMOUTH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23702-2300
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-549-9310
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | NURSE PRACTITIONER
-----------------------------------------------------
Name | MARY D ADEBOWALE
-----------------------------------------------------
Credential | DNP
-----------------------------------------------------
Telephone | 619-549-9310
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------