Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | SP024364 | PA |
NPI | 1013672849 |
---|---|
Provider Name | Cindy L Wade |
First Address | Willow Grove, PA 19090-2700 |
Second Address | Abington, PA 19001-3720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2021 |
Last Update Date | 06/11/2021 |