Individual
NACAUYA WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4907 LESABRE DR, LOUISVILLE, KY 40216-1639
(502) 445-8677
Mailing address
4156 WESTPORT RD, LOUISVILLE, KY 40207-2705
(502) 445-8677
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W99223483
DRIVERS LICENSE
—
Enumeration date
12/09/2021
Last updated
12/09/2021
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