Provider Demographics
NPI:1063085694
Name:DANIELLE WADE, PLLC
Entity type:Organization
Organization Name:DANIELLE WADE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:423-708-8670
Mailing Address - Street 1:7161 LEE HWY STE 400
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-8604
Mailing Address - Country:US
Mailing Address - Phone:423-708-8670
Mailing Address - Fax:423-708-8671
Practice Address - Street 1:7161 LEE HWY STE 400
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-8604
Practice Address - Country:US
Practice Address - Phone:423-708-8670
Practice Address - Fax:423-708-8671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty