Individual
MINDY MARIE WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, NP-C
Contact information
Practice address
1950 E FORT UNION BLVD, SALT LAKE CITY, UT 84121-6894
(801) 943-3300
Mailing address
1950 E FORT UNION BLVD, SALT LAKE CITY, UT 84121-6894
(801) 943-3300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
378455-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NONE
UT
Enumeration date
07/25/2019
Last updated
07/25/2019
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