Individual
MRS. LORI DAWN WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2000
Mailing address
10191 EVENDALE COMMONS DR, CINCINNATI, OH 45241-2689
(859) 757-6530
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1090581
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000596708
ANTHEM
—
05
—
200929950
—
IN
05
—
2939931
—
OH
05
—
7100070730
—
KY
Enumeration date
11/09/2008
Last updated
10/17/2025
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