NPI 1033447396

Carlyn Wade

Practitioner Specialist Santa Fe, NM

Practice location

Address: 2446 Avenida Chapparal, Santa Fe, NM 87505-5500
Phone: (505) 474-5969

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 4553 (NM)

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Registry record

NPI: 1033447396
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Nov 2009
Record last updated: 25 Nov 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.