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General NPI Number Information
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NPI Number | 1205821139
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Entity Type | Individual
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Provider Name | LORI A. WADE M.S.N, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 05/29/2019
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Provider Practice Location Address
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Address Line | 368 MILAN AVE STE D
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City | NORWALK
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State | OH
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Zip | 44857-3106
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Country | US
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Telephone | 419-663-6464
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Fax | 419-663-9881
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Provider Business Mailing Address
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Address Line | 368 MILAN AVE STE D
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City | NORWALK
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State | OH
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Zip | 44857-3106
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Country | US
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Telephone | 419-663-6464
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Fax | 419-663-9881
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.07457
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License Number State | OH
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