Provider Demographics
NPI:1326934738
Name:WADE, SHERYL (LPN)
Entity type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:
Last Name:WADE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:SHERYL
Other - Middle Name:
Other - Last Name:WADE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SHERYL WADE LPN
Mailing Address - Street 1:69 MANSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-9225
Mailing Address - Country:US
Mailing Address - Phone:917-772-3309
Mailing Address - Fax:
Practice Address - Street 1:69 MANSFIELD DR
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-9225
Practice Address - Country:US
Practice Address - Phone:917-772-3309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23106164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty