Stacy Wade is a Family in Fort Myers, Florida. Stacy Wade practices all healthcare services and medical treatments related to Family. The NPI Number for Stacy Wade is 1770742462. The last update date is 2023-01-04.
Stacy Wade's current location address is Po Box 2147, Fort Myers, Florida. You can contact this provider via phone number 2393433800 and fax number 2393433993. The mailing address for Stacy Wade is Po Box 2147, Fort Myers, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stacy Wade |
|---|---|
| Address | Po Box 2147, Fort Myers, Florida |
| Phone Number | 2393433800 |
| Fax Number | 2393433993 |
| Sole Proprietor | N |
| Credentials | NP |
NPI Number Detail
| NPI Number | 1770742462 |
|---|---|
| Provider Enumeration Date | 2008-06-06 |
| Last Updated Date | 2023-01-04 |
Provider Mailing Address Detail
| Address | Po Box 2147 |
|---|---|
| City | Fort Myers |
| State | Florida (FL) |
| Post Code | 339022147 |
| Phone Number | 2393433800 |
| Fax Number | 2393433993 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | 71002094A |
|
Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200903990 | IN | -- | |
| P01307686 | IN | MEDICARE RR PTAN | |
| 112417400 | FL | -- |
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What is the unique identification code assigned to Stacy Wade by the Centers for Medicare & Medicaid Services?
The Stacy Wade has been issued the NPI (National Provider Identifier) 1770742462. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Stacy Wade is physically located?
The Stacy Wade is physically situated at the following address: Po Box 2147, Fort Myers, FL, 339022147.
What is Stacy Wade's specialized field of practice, and what is the corresponding taxonomy classification code?
The Stacy Wade's area of specialization is Family, and the corresponding taxonomy code that categorizes this field of practice is 363Lf0000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1770742462 to Stacy Wade?
The Stacy Wade received its 1770742462 assignment from the Centers for Medicare & Medicaid Services on 2008-06-06.
When was the Stacy Wade's information last updated?
The Stacy Wade's information was last updated on 2023-01-04.
NPI Number: 1215930573
Address: 209 W Criser Rd, Front Royal, VA