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MS. THERESA BERGEN WADE APRN
NPI 1063497758
Nurse Practitioner - Psychiatric/Mental Health in Captain Cook, HI

Active since December 14, 2005
83-5737 KANELE ST, CAPTAIN COOK, HI 96704(808) 333-5977 Get Directions Write a Review

NPPES record last updated: January 23, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 23, 2019, Feb 9, 2016 (2 updates tracked since 2016).

About Ms. Theresa Bergen Wade Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. THERESA BERGEN WADE APRN (NPI 1063497758) is an individual psychiatric/mental health provider in Captain Cook, Hawaii, licensed in Hawaii (APRN - 1950) and active in the NPI registry since December 2005. She maintains a secondary practice location in Kealakekua.

NPPES Registry Identity

NPI1063497758
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMS. THERESA BERGEN WADECredential: APRN
Location Address83-5737 KANELE STCaptain Cook, HI 96704
Mailing Address83-5737 Kanele StCaptain Cook, HI 96704-8329 · (808) 333-5977
Phone(808) 333-5977
Sole ProprietorNo
Enumeration DateDecember 14, 2005
Last NPPES UpdateJanuary 23, 20192 updates tracked since enumeration
✔ NPI 1063497758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in HI · APRN - 1950✔ Licensed in CA · 7512
Also ListedNurse PractitionerTaxonomy 363L00000X · License 7512 (CA)
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 509869 (CA), APRN - 1950 (HI), 7512 (CA)
83-5737 KANELE ST, Captain Cook, HI 96704
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Other Names 1

Other Name (5)Ms. Theresa Annette Wade Aprn

Secondary Practice Location 1

Location 179-7446 Mamalahoa HwyKealakekua, HI 96750-7913 · Phone (808) 393-0677

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theresa Wade's NPI number?

The NPI number for Theresa Wade is 1063497758. It was assigned to this individual provider in the NPPES registry on December 14, 2005. The provider is also known as Ms. Theresa Annette Wade Aprn.

Where is Theresa Wade located?

Theresa Wade practices at 83-5737 Kanele St, Captain Cook, HI 96704. The listed phone number is (808) 333-5977.

What is Theresa Wade's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Theresa Wade was last updated on January 23, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.