Individual
MISS TRACY C WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
242 BROCKFORD RD, HEFLIN, AL 36264-1608
(256) 463-2021
(256) 463-2024
Mailing address
1411 PIEDMONT CUTOFF, GADSDEN, AL 35903-2708
(256) 492-0131
(256) 494-6000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-074382NP
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108870
—
AL
05
—
891010520
—
AL
Enumeration date
06/22/2006
Last updated
05/07/2009
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