Wade, Heather Michelle

Wade, Heather Michelle is an individual health care provider with primary practice located at 421 Kingsley Ave Ste 300 , Orange Park FL 32073-4898. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wade, Heather Michelle can be contacted via phone (904) 621-0643.

Contact Information

Primary practice address
421 Kingsley Ave Ste 300 Orange Park FL 32073-4898
Fax: (904) 621-0644
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP9206589 Florida

Profile Details

NPI number 1033136072
LBN Legal business name Wade, Heather Michelle
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2006
Last updated Aug 24th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033136072 NPPES
Florida MEDICAID 305910300

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