Individual provider · Type 1 NPI
Jacob Wade, NP
Family Nurse Practitioner · Lafayette, IN
NPI number
1629856190
Active
Practice location
2600 Greenbush St
Lafayette, IN 47904-2479
Fax (765) 447-9749
Mailing address
3907 Alex Ct
Lafayette, IN 47905-7746
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 28259521A (IN) |
| Family Nurse Practitioner Primary | 363LF0000X | 71015663A (IN) |
Family Nurse Practitioner: Definition to come...
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About NPI 1629856190
Jacob Wade, NP's National Provider Identifier is 1629856190, issued on Sep 18, 2023. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Lafayette, IN. The record was last updated on Jan 1, 2025.