Individual
MICHELLE D WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
102 IRVING ST NW, WASHINGTON, DC 20010-2921
(202) 877-7445
Mailing address
4681 DESERT RD, SUFFOLK, VA 23434-7965
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN1048132
DC
Other
Enumeration date
08/08/2019
Last updated
11/30/2021
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