NPI 1093408320

Tyesha Rochelle Wade, LPN

Practitioner Licensed Practical Nurse Columbia, SC

Practice location

Address: 3616 Kelford Dr, Columbia, SC 29209-4329
Phone: (803) 521-2848

Registered specialties

Licensed Practical Nurse Primary

Nursing Service Providers Taxonomy 164W00000X Licence 50188 (SC)

Other Licensed Practical Nurse providers in South Carolina →

Registry record

NPI: 1093408320
Entity type: Individual
Sex (as registered): Female
NPI issued: 1 Jun 2023
Record last updated: 1 Jun 2023

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.