| Coty Darnell Wade, CRNP | |
|
195 Hospital Dr, Centreville, AL 35042-2935 | |
| (205) 926-2993 | |
| Not Available |
| Full Name | Coty Darnell Wade |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 195 Hospital Dr, Centreville, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144305053 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163WG0600X | Registered Nurse - Gerontology | 1-097913 (Alabama) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 1-097913 (Alabama) | Primary |
| Entity Name | West Alabama Family Practice & Sports Medicine Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376615476 PECOS PAC ID: 1254236755 Enrollment ID: O20031205000620 |
| Mailing Address | Practice Location Address |
|---|---|
| Coty Darnell Wade, CRNP 11954 Foundry Cir, Mc Calla, AL 35111-2590 Ph: (205) 938-3437 | Coty Darnell Wade, CRNP 195 Hospital Dr, Centreville, AL 35042-2935 Ph: (205) 926-2993 |
Kimberly Lawayne Johnson, RN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 405 Belcher St, Centreville, AL 35042 Phone: 205-926-2992 | |
Hannah Simpson, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 405 Belcher St, Centreville, AL 35042 Phone: 205-926-2992 | |
Stephanie Savage, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 405 Belcher St, Centreville, AL 35042 Phone: 205-926-2992 | |
Robin Michelle Birchfield, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 208 Pierson Avenue, Centreville, AL 35042 Phone: 205-926-4694 Fax: 205-926-3248 | |
Amber Nicole Yartins, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 405 Belcher St, Centreville, AL 35042 Phone: 205-926-2992 | |
Mr. Joshua Elledge, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 405 Belcher St, Centreville, AL 35042 Phone: 205-926-2992 Fax: 205-316-7675 | |
Mrs. Karlee Johnson Bradford, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 208 Pierson Ave, Centreville, AL 35042 Phone: 205-926-4881 |