Individual
DONNA C WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
200 PATEWOOD DR, SUITE A140, GREENVILLE, SC 29615-3593
(864) 454-5125
(864) 454-5131
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8614
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
100
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0225
—
SC
Enumeration date
06/07/2006
Last updated
06/07/2021
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