Provider Demographics
NPI:1811474190
Name:CADE, EDDREA WARD (NP-C)
Entity type:Individual
Prefix:MRS
First Name:EDDREA
Middle Name:WARD
Last Name:CADE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MRS
Other - First Name:EDDREA
Other - Middle Name:LAVONIELLE
Other - Last Name:WARD-CADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1825 HEATHERTON DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3034
Mailing Address - Country:US
Mailing Address - Phone:334-318-8723
Mailing Address - Fax:
Practice Address - Street 1:129 MITYLENE PARK LN
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-7302
Practice Address - Country:US
Practice Address - Phone:334-279-8180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-110178363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily