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Individual
CAROL R WADE
Active
Individual
CAROL R WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R085542
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639118011
—
DE
05
—
406341400
—
MD
01
—
644044-01
BLUE CROSS/BLUE SHIELD
MD
Enumeration date
06/04/2006
Last updated
04/24/2008
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