Healthcare Provider Details

I. General information

NPI: 1114869625
Provider Name (Legal Business Name): ROMIKA LASHAWN WADE MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 RICHLAND MEDICAL PARK DR
COLUMBIA SC
29203-6863
US

IV. Provider business mailing address

127 MEADOW SPRINGS DR
COLUMBIA SC
29229-6881
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-7000
  • Fax:
Mailing address:
  • Phone: 803-434-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number32790
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: