Individual provider · Type 1 NPI
Kenya Michelle Wade, CPNP
Pediatric Nurse Practitioner · Dumfries, VA
NPI number
1265707160
Active
Practice location
3700 Fettler Park Dr
Dumfries, VA 22025-2050
Mailing address
28 Christopher Way
Stafford, VA 22554-7811
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 5005514 (NC) |
| Pediatric Nurse Practitioner Primary | 363LP0200X | 0024174942 (VA) |
Pediatric Nurse Practitioner: Definition to come...
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Other pediatric nurse practitioner providers in Dumfries
About NPI 1265707160
Kenya Michelle Wade, CPNP's National Provider Identifier is 1265707160, issued on Mar 12, 2012. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Dumfries, VA. The record was last updated on Jul 21, 2022.