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General NPI Number Information
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NPI Number | 1891153441
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Entity Type | Individual
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Provider Name | DANIEL WADE PRICE NP
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Gender | Male
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Dates
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Enumeration Date | 02/10/2016
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | 427 HIGHWAY 51 N
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City | BROOKHAVEN
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State | MS
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Zip | 39601-2350
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Country | US
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Telephone | 601-833-6011
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Fax |
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Provider Business Mailing Address
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Address Line | 1558 MAURA LN SE
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City | BROOKHAVEN
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State | MS
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Zip | 39601-8966
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Country | US
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Telephone | 601-384-6285
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 901451
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 901451
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License Number State | MS
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