Individual
MRS. JENNIFER LISA WOLVERTON-WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CWCN
Contact information
Practice address
3000 41ST ST, MARATHON, FL 33050
(305) 434-7660
Mailing address
210 KEY HONEY LANE, TAVERNIER, FL 33070
(860) 328-0013
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN9333023
FL
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
RN9333023
FL
163WW0000X
Wound Care Registered Nurse
RN9333023
FL
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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