Individual
MS. KERRI RANDENE WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, BC, PNP
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3581
(816) 234-3589
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3581
(816) 234-3589
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
092706
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100415200A
—
KS
05
—
425770708
—
MO
Enumeration date
04/25/2006
Last updated
01/04/2012
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