Provider Demographics
NPI:1477273001
Name:WADE, ERICA MELISSA (MS)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:MELISSA
Last Name:WADE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11260 N 92ND ST UNIT 2029
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6172
Mailing Address - Country:US
Mailing Address - Phone:310-433-5798
Mailing Address - Fax:
Practice Address - Street 1:11260 N 92ND ST UNIT 2029
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6172
Practice Address - Country:US
Practice Address - Phone:310-433-5798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker