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General NPI Number Information
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NPI Number | 1720898372
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Entity Type | Individual
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Provider Name | SYDNEY CAROLINE WADE
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Gender | Female
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 615 MCCALLIE AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37403-2504
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Country | US
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Telephone | 423-425-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 112 MULLEN AVE
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City | NETTLETON
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State | MS
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Zip | 38858-6032
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Country | US
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Telephone |
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 918371
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License Number State | MS
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