Individual
TAMMY WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2112 F ST NW STE 102, WASHINGTON, DC 20037-2722
(202) 296-4455
(202) 822-9130
Mailing address
6337 LANDOVER RD APT 303, CHEVERLY, MD 20785-1337
(240) 667-6617
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
LP43468
MD
164W00000X
Licensed Practical Nurse
Primary
LPN1004141
DC
Other
Enumeration date
03/23/2021
Last updated
03/23/2021
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