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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MS. THERESA BERGEN WADE, APRN

Active

Psychiatric/Mental Health Nurse Practitioner · CAPTAIN COOK, HI

Registration Details

NPI Number
1063497758
Provider Type
Individual
Gender
Female
NPI Issued
Dec 14, 2005 (20.353496111986 yrs)
Last Updated
Jan 23, 2019
Licenses
7512 (CA)
APRN - 1950 (HI)
7512 (CA)
509869 (CA)
7512 (CA)

Practice Information

Address
83-5737 KANELE ST
CAPTAIN COOK, HI, 96704
Browse HI providers · Browse ZIP 96704
Phone
8083335977
Additional Specialty
Nurse Practitioner
Additional Specialty
Family Nurse Practitioner
Additional Specialty
Family Nurse Practitioner
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.