Provider Demographics
NPI:1881496685
Name:WADE, NAIMA R (RN)
Entity type:Individual
Prefix:MS
First Name:NAIMA
Middle Name:R
Last Name:WADE
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2579 IRWIN BRIDGE RD NW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-2701
Mailing Address - Country:US
Mailing Address - Phone:678-755-8579
Mailing Address - Fax:
Practice Address - Street 1:2579 IRWIN BRIDGE RD NW
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-2701
Practice Address - Country:US
Practice Address - Phone:678-755-8579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA115918163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health