Provider Demographics
NPI:1851624837
Name:WADE, VIRGINIA L (CNM)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:L
Last Name:WADE
Suffix:
Gender:F
Credentials:CNM
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Other - Credentials:
Mailing Address - Street 1:324 N QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-4932
Mailing Address - Country:US
Mailing Address - Phone:252-522-9800
Mailing Address - Fax:252-522-9854
Practice Address - Street 1:102 HANDLEY PARK CT
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1768
Practice Address - Country:US
Practice Address - Phone:919-734-3344
Practice Address - Fax:919-735-3025
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2019-12-13
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13053OtherAMERICAN MIDWIFERY CERTIFICATION