Individual
MILAN JOHNSON WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
5959 HIGHWAY 53 E STE 100, DAWSONVILLE, GA 30534-6288
(706) 381-6125
(706) 531-0075
Mailing address
PO BOX 307, CUMMING, GA 30028-0307
(770) 887-1668
(770) 781-9937
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN234027
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003202448A
—
GA
Enumeration date
02/28/2018
Last updated
01/19/2023
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