| Organization Name: | SANDRA M. WADE, FNP INC. |
| NPI Number: | 1184834541 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SANDRA M WADE (PRACTITIONER) |
| Mailing Address: | 2415 N Gateway Ave Harriman |
| State: | TN US |
| Postal Code: | 377488609 |
| Phone Number: | 8658822002 |
| Fax Number: | 8655900475 |
| NPI Enumeration Date: | 05/23/2007 |
| NPI Last Update Date: | 02/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APN000005322 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |