| Doctor Name: | MS. MARY LYNETTE WADE |
| NPI Number: | 1710953195 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, CFNP |
| License Number: | RN035495 3693 |
| Business Practice Address: | 1025 Marion Hwy Farmerville, LA - 712419314 |
| Business Phone Number: | 3183689745 |
| Business Fax Number: | 3183680072 |
| Mailing Address: | 121 Percy Rd, FARMERVILLE |
| State: | LA |
| Postal Code: | 712418161 |
| Phone Number: | 3183683560 |
| Fax Number: | |
| NPI Enumeration Date: | 02/27/2006 |
| NPI Last Update Date: | 12/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN035495 3693 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |