Organization
WADE FAMILY MEDICINE, LLC.
Active
Organization
WADE FAMILY MEDICINE, LLC.
Active
Other names
Wade Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MODEANNA LEIGH WADE (FNP)
(901) 244-4648
Entity
Organization
Contact information
Practice address
899 HIGHWAY 51 S, COVINGTON, TN 38019-2568
(901) 244-4646
(901) 244-4647
Mailing address
PO BOX 369, MILLINGTON, TN 38083-0369
(901) 244-4648
(901) 244-4647
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
16204
TN
261QR1300X
Rural Health Clinic/Center
16204
TN
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1525986
—
TN
Enumeration date
01/16/2018
Last updated
07/09/2024
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