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Contact Information

KEN WADE, CRNA
9601 INTERSTATE 630 EXIT 7
LITTLE ROCK, AR72205-7202
 Phone: 501-202-2093
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for KEN WADE · (Male)

NPI # 1013076801
Status Active
Credentials CRNA (Certified Registered Nurse Anesthetist)
Entity Individual
Enumeration date 12/07/2006
Last updated 05/16/2008 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • AR License # C00324
  • AR Medicaid 136873701
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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