Individual
MS. DAWN WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
15778 W YUMA RD, GOODYEAR, AZ 85338-3358
(623) 932-7500
Mailing address
8780 E MCKELLIPS RD LOT 475, SCOTTSDALE, AZ 85257-4803
(775) 379-8258
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP041423
AZ
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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