Individual
KRISTIE WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
308 CHESTER AVE, GREAT FALLS, SC 29055-1104
(803) 482-2129
Mailing address
859 DAISYWOOD LN, CHESTER, SC 29706-8799
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
106459
SC
363LF0000X
Family Nurse Practitioner
Primary
24388
SC
Other
Enumeration date
01/24/2017
Last updated
07/22/2021
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