Individual
ELENA WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
616 MARKET ST, MEDFORD, OR 97504-6126
(541) 535-6239
Mailing address
931 CHEVY WAY, MEDFORD, OR 97504-4127
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
10007541
OR
363LF0000X
Family Nurse Practitioner
ARNP9263582
FL
Other
Enumeration date
09/13/2013
Last updated
06/09/2023
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