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NPI Code Detail

MEDICARE: PATRICIA S WADE FNP

MEDICARE: PATRICIA S WADE FNP
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 Practitioner220320CA

General Provider Information

NPI Number : 1497850150
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA S WADE FNP
Provider Business Mailing Address
First Line : 10885 TELEGRAPH RD
Second Line :
City : VENTURA
State : CA
Zip : 93004-1272
Country : US
Telephone Number : 805-647-7704
Fax Number : 805-647-7084
Provider Business Practice Location Address
First Line : 10885 TELEGRAPH RD
Second Line :
City : VENTURA
State : CA
Zip : 93004-1272
Country : US
Telephone Number : 805-647-7704
Fax Number : 805-647-7084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 12/03/2009

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Directions to “ PATRICIA S WADE FNP” Practice Location

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