Individual
JONATHAN WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN-CRNA
Contact information
Practice address
601 W LEOTA ST, NORTH PLATTE, NE 69101-6525
(308) 568-8470
Mailing address
9005 LAKEVIEW DR, NORTH PLATTE, NE 69101-9489
(208) 351-5470
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
101511
NE
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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