Provider Demographics
NPI:1194696401
Name:EMADES WOUND CARE PLLC
Entity type:Organization
Organization Name:EMADES WOUND CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:D
Authorized Official - Last Name:ADEBOWALE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:619-549-9310
Mailing Address - Street 1:14 HOLLY HILL LN
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23702-2300
Mailing Address - Country:US
Mailing Address - Phone:619-549-9310
Mailing Address - Fax:
Practice Address - Street 1:14 HOLLY HILL LN
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23702-2300
Practice Address - Country:US
Practice Address - Phone:619-549-9310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care