William L Wade, APRN
Individual provider Active NPI Family Nurse Practitioner · Eldorado, KS
NPI 1316341027 · NPPES record last updated Oct 9, 2014
Key facts
- NPI
- 1316341027
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 53-76580-061 (KS)
- Practice address
- 1737 SE Highway 54
Eldorado, KS 67042 - Phone
- (316) 321-7284
- NPI assigned
- Oct 9, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53-76580-061 | KS | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 53-76580-061 | KS | Yes |
Addresses
Primary practice location
1737 SE Highway 54
Eldorado, KS 67042
Mailing address
1827 Lawndale Ave
El Dorado, KS 67042-4042
Phone (316) 323-4807
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.