| Doctor Name: | HEATHER MICHELLE WADE |
| NPI Number: | 1033136072 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | A.R.N.P. |
| License Number: | ARNP9206589 |
| Business Practice Address: | 1409 Kingsley Ave 6a Orange Park, FL - 320734537 |
| Business Phone Number: | 9042647517 |
| Business Fax Number: | 9042640015 |
| Mailing Address: | Po Box 850001, ORLANDO |
| State: | FL |
| Postal Code: | 328850192 |
| Phone Number: | 9042826331 |
| Fax Number: | 9042824117 |
| NPI Enumeration Date: | 07/16/2006 |
| NPI Last Update Date: | 08/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ARNP9206589 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |