| Doctor Name: | MRS. JENNIFER KATHERINE WADE |
| NPI Number: | 1053736231 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | R194448 |
| Business Practice Address: | 41680 Miss Bessie Dr Suite 301 Leonardtown, MD - 206502906 |
| Business Phone Number: | 3019970055 |
| Business Fax Number: | |
| Mailing Address: | 1512 Abbey Ln, HUNTINGTOWN |
| State: | MD |
| Postal Code: | 206392310 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/25/2014 |
| NPI Last Update Date: | 02/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WM0705X |
| License Number: | R194448 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Medical-Surgical |
| Taxonomy Definition: | |