Individual
WADE GILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
4201 NELSON RD STE 100, LAKE CHARLES, LA 70605-4187
(337) 310-2273
(337) 310-4520
Mailing address
4201 NELSON RD STE 100, LAKE CHARLES, LA 70605-4187
(337) 310-2273
(337) 310-4520
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
212171
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2573063
—
LA
Enumeration date
04/09/2020
Last updated
08/15/2022
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