Jennifer M Wade, LPN

Individual provider Active NPI Licensed Practical Nurse · Sebring, OH

NPI 1528318219 · NPPES record last updated Dec 5, 2012

Key facts

NPI
1528318219
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
147731 (OH)
Practice address
165 E Ohio Ave
Sebring, OH 44672-1410
Phone
(330) 257-1780
NPI assigned
Sep 11, 2012
Sex
Female
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

LicenseStateTypeSpecialty
147731OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 147731 OH Yes

Addresses

Primary practice location

165 E Ohio Ave
Sebring, OH 44672-1410

Mailing address

165 E Ohio Ave
Sebring, OH 44672-1410
Phone (330) 257-1780

Other providers in Sebring, OH

All providers in Sebring, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.