Individual
MRS. TERRA BROOKE WADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
828 LANE ALLEN RD STE 219, LEXINGTON, KY 40504-3659
(443) 383-9300
(855) 866-8710
Mailing address
909 RIDGEBROOK RD STE 300, SPARKS GLENCOE, MD 21152-9477
(443) 383-9300
(855) 866-8710
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
3013345
KY
363LA2200X
Adult Health Nurse Practitioner
3013345
KY
363LG0600X
Gerontology Nurse Practitioner
Primary
3013345
KY
Other
Enumeration date
12/01/2019
Last updated
11/17/2022
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