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NPI Code Detail

MEDICARE: SCARLETT ANN WADE FNP-C

MEDICARE: SCARLETT ANN WADE FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN204241GA
2363LX0001XObstetrics & Gynecology Nurse PractitionerRN204241GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN204241OTHERGAGEORGIA NP LICENSE

General Provider Information

NPI Number : 1013387331
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCARLETT ANN WADE FNP-C
Provider Business Mailing Address
First Line : 414 5TH AVE
Second Line :
City : ALBANY
State : GA
Zip : 31701-1976
Country : US
Telephone Number : 229-883-4555
Fax Number : 229-883-4555
Provider Business Practice Location Address
First Line : 414 5TH AVE
Second Line :
City : ALBANY
State : GA
Zip : 31701-1976
Country : US
Telephone Number : 229-883-4555
Fax Number : 229-888-0063
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2015
Last Update Date : 06/21/2022

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Directions to “ SCARLETT ANN WADE FNP-C” Practice Location

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