Individual provider · Type 1 NPI
Ethlene Evette Dade, FNP
Family Nurse Practitioner · Long Beach, CA
NPI number
1417649013
Active
Practice location
200 Oceangate Ste 100
Long Beach, CA 90802-4317
Mailing address
14390 Dalton Ct
Victorville, CA 92394-3212
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1208802 (TX) |
| Family Nurse Practitioner Primary | 363LF0000X | 95025043 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1417649013
Ethlene Evette Dade, FNP's National Provider Identifier is 1417649013, issued on May 23, 2023. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Long Beach, CA. The record was last updated on Dec 16, 2025.