MILAN JOHNSON WADE CPNP NPI 1174024780

NPI Information

  • NPI: 1174024780
  • Provider Name: MILAN JOHNSON WADE, CPNP
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5959 HIGHWAY 53 E STE 100
    DAWSONVILLE, GA
    ZIP 30534
  • Phone: (706) 381-6125

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NPI Details

Milan Johnson Wade, CPNP is a pediatrics nurse practitioner in Dawsonville, GA. Milan Johnson Wade, CPNP NPI is 1174024780. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5959 HIGHWAY 53 E STE 100
DAWSONVILLE, GA
ZIP 30534-288
Phone: (706) 381-6125
Fax: (706) 531-0075

The NPI 1174024780 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/28/2018 and was last updated on 1/19/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatricsRN234027GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1003202448AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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