Individual
MRS. JACQUI LORRAINE WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN., BSN
Contact information
Practice address
12357 ORCHARD WOOD DR, FENTON, MI 48430-8434
(810) 629-6626
(810) 629-6625
Mailing address
12357 ORCHARD WOOD DR, FENTON, MI 48430-8434
(810) 629-6626
(810) 629-6625
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704224400
MI
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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