Provider Demographics
NPI:1487958302
Name:WADEI, ELIZABETH A (APRN FNP-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:WADEI
Suffix:
Gender:F
Credentials:APRN FNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 E DUBLIN GRANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3209
Mailing Address - Country:US
Mailing Address - Phone:614-574-1823
Mailing Address - Fax:614-420-2229
Practice Address - Street 1:691 E DUBLIN GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3209
Practice Address - Country:US
Practice Address - Phone:614-574-1823
Practice Address - Fax:614-420-2229
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0028939363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAPRN.CNP.0028939OtherMEDICARE
OH1487958302Medicaid