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General NPI Number Information
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NPI Number | 1316341027
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Entity Type | Individual
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Provider Name | WILLIAM L WADE APRN
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Gender | Male
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Dates
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Enumeration Date | 10/09/2014
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Last Update Date | 10/09/2014
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Provider Practice Location Address
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Address Line | 1737 SE HIGHWAY 54
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City | ELDORADO
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State | KS
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Zip | 67042
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Country | US
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Telephone | 316-321-7284
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Fax |
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Provider Business Mailing Address
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Address Line | 1827 LAWNDALE AVE
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City | EL DORADO
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State | KS
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Zip | 67042-4042
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Country | US
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Telephone | 316-323-4807
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Fax |
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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 | 53-76580-061
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License Number State | KS
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