Individual
VICKIE C. WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-C
Contact information
Practice address
5701 DELMAR BLVD, SAINT LOUIS, MO 63112-2617
(314) 367-7848
(314) 367-2985
Mailing address
5701 DELMAR BLVD, SAINT LOUIS, MO 63112-2617
(314) 367-7848
(314) 367-2985
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
095910
MO
363LW0102X
Women's Health Nurse Practitioner
RN095910
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
423909811
—
MO
Enumeration date
07/06/2006
Last updated
06/22/2011
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