Provider Demographics
NPI:1821730946
Name:WADE, BRITTANY ERIN (APRN)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ERIN
Last Name:WADE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:ERIN
Other - Last Name:BLUETHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10201 KANIS RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6203
Mailing Address - Country:US
Mailing Address - Phone:501-227-5050
Mailing Address - Fax:501-227-5151
Practice Address - Street 1:10201 KANIS RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6203
Practice Address - Country:US
Practice Address - Phone:501-227-5050
Practice Address - Fax:501-227-5151
Is Sole Proprietor?:No
Enumeration Date:2022-04-09
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR125507363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily