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Lisa Marie Wade
Family Nurse Practitioner in West Plains, Missouri
NPI 1710379201

Lisa Marie Wade is a Family Nurse Practitioner based in West Plains, MO and is specialized in Family. Lisa Marie Wade practices in West Plains, MO. The NPI Number for Lisa Marie Wade is 1710379201 and holds a License No. 2015005062 (Missouri).

The current practice location address for Lisa Marie Wade is 1307 Porter Wagoner Blvd, West Plains, MO and can be reached out via phone at 417-255-8645.

Location: 1307 Porter Wagoner Blvd, West Plains, MO, 65775-1571
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Provider Profile Details
NPI Number
1710379201
Provider Name
Lisa Marie Wade
Credential
Provider Entity Type
Individual
Gender
Female
Address
1307 Porter Wagoner Blvd, West Plains, MO, 65775-1571
Phone Number
417-255-8645
Fax Number
Provider Enumeration Date
02/20/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
F0215049 01 MO AANP CERTIFICATION
institution
Provider Business Practice Location Address Details
Address
1307 Porter Wagoner Blvd
City
State
Zip
65775-1828
Phone Number
417-255-8645
Fax Number
person
Provider Business Mailing Address Details
Address
1307 Porter Wagoner Blvd
City
State
Zip
65775-1828
Phone Number
417-255-8645
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
2015005062 (Missouri)
Definition
Definition to come...
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