Individual
KIMBERLY MARIE WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-3153
Mailing address
1 ATWELL RD, COOPERSTOWN, NY 13326-1301
(607) 547-3153
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
623182
NY
Other
Enumeration date
10/29/2009
Last updated
10/29/2009
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