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Individual

REGINA WADE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
211 SPARKS ST, PHILADELPHIA, PA 19120-1416
(215) 290-6741
Mailing address
211 SPARKS ST, PHILADELPHIA, PA 19120-1416
(215) 290-6741

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN620967
PA

Other

Enumeration date
04/30/2024
Last updated
04/30/2024
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