Individual provider · Type 1 NPI
Crystal Ann Wade, MSN, AG-ACNP-BC
Adult Health Nurse Practitioner · Jacksonville, FL
NPI number
1073173142
Active
Practice location
12574 Flagler Center Blvd Ste 101
Jacksonville, FL 32258-2615
Fax (904) 582-1608
Mailing address
2285 Marsh Hawk Ln Apt 13102
Fleming Island, FL 32003-3309
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | 11002837 (FL) |
| Family Nurse Practitioner | 363LF0000X | 11002837 (FL) |
| Adult Health Nurse Practitioner Primary | 363LA2200X | 11002837 (FL) |
Adult Health Nurse Practitioner: Definition to come...
4 other providers at this address
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- Stacy Laine Pike, PSY.D.Clinical Psychologist Jacksonville, FL NPI 1205532793
- Victoria Kozel, NPPsychiatric/Mental Health Nurse Practitioner Jacksonville, FL NPI 1518031202
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- Tanya Paradiso Dilmuth, ARNPAdult Health Nurse Practitioner Jacksonville, FL NPI 1013391994
- Gentina Victoria Kennedy, APRNAdult Health Nurse Practitioner Jacksonville, FL NPI 1013581750
- Diana Van Precht Crowe, ARNPAdult Health Nurse Practitioner Jacksonville, FL NPI 1023090446
- Anthony Atwood Premo, APRN, AGACNP-BCAdult Health Nurse Practitioner Jacksonville, FL NPI 1033840806
- Chanel Scott, APRNAdult Health Nurse Practitioner Jacksonville, FL NPI 1053093138
About NPI 1073173142
Crystal Ann Wade, MSN, AG-ACNP-BC's National Provider Identifier is 1073173142, issued on Jun 19, 2019. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Jacksonville, FL. The record was last updated on Aug 28, 2026.