Provider Demographics
NPI:1083725329
Name:WADE, JULIE A (RN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:WADE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1086
Mailing Address - Street 2:
Mailing Address - City:YREKA
Mailing Address - State:CA
Mailing Address - Zip Code:96097-1086
Mailing Address - Country:US
Mailing Address - Phone:530-842-9700
Mailing Address - Fax:530-842-9054
Practice Address - Street 1:105 E OBERLIN RD
Practice Address - Street 2:
Practice Address - City:YREKA
Practice Address - State:CA
Practice Address - Zip Code:96097-9553
Practice Address - Country:US
Practice Address - Phone:530-842-9700
Practice Address - Fax:530-842-9054
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARN2741592471B0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471B0102XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistBone Densitometry