Tyra Wade, is a
Case Manager/care Coordinator based in Jackson, Mississippi. Tyra Wade is licensed to practice in * (Not Available) (license number ) and her current practice location is
4780 I 55 N Ste 105, Jackson, Mississippi. She can be reached at her office (for appointments etc.) via phone at
(601) 956-4816.
NPI number for Tyra Wade is 1477735769 and her current mailing address is 4780 I 55 N Ste 105, Jackson, Mississippi. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1477735769.
Healthcare Provider's Profile
| Full Name | Tyra Wade |
|---|
| Gender | Female |
|---|
| Speciality | Case Manager/care Coordinator |
|---|
| Location | 4780 I 55 N Ste 105, Jackson, Mississippi |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1477735769
- Provider Enumeration Date: 11/29/2007
- Last Update Date: 03/10/2022
Medical Identifiers
Medical identifiers for Tyra Wade such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1477735769 | NPI | - | NPPES |
| 01670076 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tyra Wade is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tyra Wade,
4780 I 55 N Ste 105,
Jackson, MS 39211-5542
Ph: (601) 956-4816 | Tyra Wade,
4780 I 55 N Ste 105,
Jackson, MS 39211-5542
Ph: (601) 956-4816 |
Reviews and Comments