Individual
NANCY EARLINE WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
738 N PARKWOOD RD, DECATUR, GA 30030-5024
(678) 612-2456
(404) 378-5761
Mailing address
738 N PARKWOOD RD, DECATUR, GA 30030-5024
Taxonomy
Speciality
Code
Description
License number
State
163WE0900X
Enterostomal Therapy Registered Nurse
Primary
RN088948
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83-02690
UNITED HEALTHCARE
GA
Enumeration date
12/08/2006
Last updated
07/08/2007
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