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NPI Code Detail

MEDICARE: LAURA WADE HARRIS

MEDICARE: LAURA WADE HARRIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantNC
2363AS0400XSurgical Physician AssistantNC

General Provider Information

NPI Number : 1710839774
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA WADE HARRIS
Provider Business Mailing Address
First Line : 1915 LENDEW ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27408-7033
Country : US
Telephone Number : 336-275-3325
Fax Number : 336-275-5346
Provider Business Practice Location Address
First Line : 1915 LENDEW ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27408-7033
Country : US
Telephone Number : 336-275-3325
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2026
Last Update Date : 02/23/2026

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Directions to “ LAURA WADE HARRIS ” Practice Location

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