Kistricia Breyanna Wade, CNA

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

5899646 Issued in SC

Practice address

1815 Central Park Rd Apt F10
Charleston, SC 29412-2807

Phone

(843) 925-2995

NPI assigned

Nov 4, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1629891072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 CENTRAL PARK RD APT F10",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122807",
            "telephone_number": "843-925-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 CENTRAL PARK RD APT F10",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122807",
            "telephone_number": "843-925-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "KISTRICIA",
        "middle_name": "BREYANNA",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "SC",
            "license": "5899646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald F Wade, M.D.
• Graham Clarkson Wade, PT
• Jennifer Boyland Wade, D.D.S.
• Jessica Feltracco Wade
• Kathryn Anne Wade, PA
• Lakosha T Wade, NP
• Mason Wade, D.M.D.
• Morgan Wade
• Ghassan Jamal Wadi, MD
• Kerri Ann Waegelein, DPT, OCS

• Personal Care Attendant in Charleston, SC
• Providers in Charleston, SC by specialty
• Personal Care Attendant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.