LALISA WADE (NPI# 1710161385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710161385 |
| Entity Type | Individual |
| Full Name | LALISA WADE |
| Credential | FAMILY NURSE PRACTIT |
| Practice Address |
520 Durham St Bastrop LA 71220-5013 |
| Practice Telephone | 3182838887 |
| Mailing Telephone | 3182838887 |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2012-02-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN101774 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1032671 | 05 |
| Street Address |
520 DURHAM ST |
| City | BASTROP |
| State | LA |
| Zip Code | 71220-5013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952935983 | Broken Wings Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 2869 New Monroe Road, Bastrop, LA 71220 | 2020-02-28 |
| 1275002685 | Hulin Urgent Care Services, LLC | Clinic/Center | 2100 East Madison Avenue, Bastrop, LA 71220 | 2018-11-14 |
| 1023594975 | Shuntel Ramona Johnson | Counselor | 8891 Holley Farm Road, Bastrop, LA 71220 | 2018-07-13 |
| 1376050526 | Kevin Hubbard | Case Manager/Care Coordinator | 9409 Willow Dr, Bastrop, LA 71220 | 2018-01-09 |
| 1265957229 | Alma Holmes | Behavioral Analyst | 644 E. Jefferson Ave, Bastrop, LA 71220 | 2017-08-10 |
| 1427570886 | Jennifer Rochelle Glosson | Counselor | 410 S. Franklin St, Bastrop, LA 71220 | 2017-07-07 |
| 1386179307 | Total Divine Care LLC | Community/Behavioral Health | 1840 North Washington Street, Bastrop, LA 71220 | 2017-04-27 |
| 1538609524 | Tyrra Watkins | Counselor | 10599 Parkwood Dr, Bastrop, LA 71220 | 2017-02-24 |
| 1528502119 | Oatie Brooks | Counselor | 813 Mccreight Street, Bastrop, LA 71220 | 2016-12-15 |
| 1487197810 | Valencia Reese | Counselor | 10434 Boswell St, Bastrop, LA 71220 | 2016-12-03 |
| Find all providers in zip 71220 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619518693 | Kaitlyn Johnston | Nurse Practitioner | 510 S. Washington St, Bastrop, LA 71220-4043 | 2019-10-01 |
| 1659840262 | Lakisher Bonner Morgan | Nurse Practitioner | 6175 Polaris Dr, Bastrop, LA 71220-3476 | 2018-11-14 |
| 1255884532 | Sarah Cervantes | Nurse Practitioner | 208 Shiloh Rd, Bastrop, TX 78602-4040 | 2016-08-03 |
| 1770830473 | Sarah Beth Chavez | Nurse Practitioner | 717 Highway 71 W Ste 500, Fastmed Urgent Care, Bastrop, TX 78602-4148 | 2012-08-13 |
| 1700862497 | Joy Chioma Nwanganga | Nurse Practitioner | 489 Agnes St Ste 100, Bastrop, TX 78602-2157 | 2005-12-15 |
| 1932749769 | Elizabeth Ann Brown | Nurse Practitioner | 1109 Church St, Bastrop, TX 78602-3206 | 2020-01-09 |
| 1770134025 | Jihong Kim | Nurse Practitioner | 489 Agnes St Ste 100, Bastrop, TX 78602-2157 | 2019-09-26 |
| 1770065799 | Brenton Lee Albritton | Nurse Practitioner | 518 Durham St, Bastrop, LA 71220-5013 | 2018-09-06 |
| 1144728494 | Elizabeth Hoskins | Nurse Practitioner | 518 Durham St, Bastrop, LA 71220-5013 | 2018-01-31 |
| 1013424670 | Tiffany Tolliver-battle | Nurse Practitioner | 221 W Hickory Ave, Bastrop, LA 71220-4551 | 2018-01-04 |
| Find all providers in BASTROP | ||||
Please comment or provide details below to improve the information on LALISA WADE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.