Individual
MRS. JENNI DAVIS WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
116 MIMOSA DR, THOMASVILLE, GA 31792-6605
(229) 551-0083
Mailing address
116 MIMOSA DR, THOMASVILLE, GA 31792-6605
(229) 584-5570
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN 197857
GA
Other
Enumeration date
07/20/2015
Last updated
11/19/2020
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