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NPI Code Detail

MEDICARE: KATHLEEN A WADE N.P.

MEDICARE: KATHLEEN A WADE N.P.
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 Practitioner0024468818VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245270818
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN A WADE N.P.
Provider Business Mailing Address
First Line : PO BOX 746871
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6871
Country : US
Telephone Number : 469-727-6675
Fax Number :
Provider Business Practice Location Address
First Line : 5246 CHAMBERLAYNE RD
Second Line :
City : RICHMOND
State : VA
Zip : 23227-2950
Country : US
Telephone Number : 804-913-7029
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 05/13/2024

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