# THERESA WADE, APRN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861850570
- **Authorized official:** MS. THERESA WADE APRN (SOLE PROPRIETOR)
- **Authorized official phone:** (808) 333-5977

## Contact information

- **Practice address:** 79-7446 MAMALAHOA HWY, KEALAKEKUA, HI 96750-7913
- **Practice address phone:** (808) 393-0677
- **Mailing address:** 83-5737 KANELE ST, CAPTAIN COOK, HI 96704-8329

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | APRN-1950 | HI | Yes |

## Other

- **Enumeration date:** 02/09/2016
- **Last updated:** 02/09/2016