Provider Demographics
NPI:1356518872
Name:WADE, ALLISON KRINER (CRNP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:KRINER
Last Name:WADE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 E ANTIETAM ST STE 1
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5767
Mailing Address - Country:US
Mailing Address - Phone:304-393-5094
Mailing Address - Fax:855-631-6386
Practice Address - Street 1:339 E ANTIETAM ST STE 1
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5767
Practice Address - Country:US
Practice Address - Phone:304-393-5094
Practice Address - Fax:855-631-6386
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR135020363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily