Individual
MRS. LORETTA NADINE WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
26180 WEST OUTER DRIVE, LINCOLN PARK, MI 48146
(313) 389-2209
Mailing address
17526 SHAFTSBURY AVE, DETROIT, MI 48219-3544
(313) 255-0418
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704096674
MI
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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