Healthcare Provider Details

I. General information

NPI: 1427988476
Provider Name (Legal Business Name): ERICA REID WADE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 HUDSON AVE
DURHAM NC
27705-3353
US

IV. Provider business mailing address

9556 WILLIAMSON RD
BULLOCK NC
27507-9443
US

V. Phone/Fax

Practice location:
  • Phone: 919-299-3050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: