Judi Gail Wade, RN
Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Harrison Township, MI
NPI 1609007657 · NPPES record last updated Aug 6, 2009
Key facts
- NPI
- 1609007657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Registered Nurse 163WP0808X
- License
- 4704155759 (MI)
- Practice address
- 39161 Shoreline Dr
Harrison Township, MI 48045-1799 - Phone
- (586) 944-1052
- NPI assigned
- Aug 6, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704155759 | MI | MD | Psychiatric/Mental Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 4704155759 | MI | Yes |
Addresses
Primary practice location
39161 Shoreline Dr
Harrison Township, MI 48045-1799
Mailing address
39161 Shoreline Dr
Harrison Township, MI 48045-1799
Phone (586) 944-1052
Other providers in Harrison Township, MI
- St. John North Shores Hospital
- Laura Starr
- The Blue House Company LLC
- The Sharon Elaine Foundation
- Totally Excellent Care, Inc.
- We Care Home Inc.
- Ashante Whitehurst
- Steven S Wood
- Elizabeth Mary Zinser
All providers in Harrison Township, MI · Psychiatric/Mental Health Registered Nurse in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2009. 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.