IndividualActive
Avita Wade
NPI 1023608957 · Licensed Practical Nurse · Charlotte, NC
Provider details
- NPI number
- 1023608957
- Entity type
- Individual
- Primary specialty
- Licensed Practical NurseNursing Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 089017 (NC)
Specialties & taxonomies
Nursing Service Providers
Practice location
5110 Misty Oaks Dr Apt 1813
Charlotte, NC 28269-4397
Phone: (843) 641-8326
Approximate (ZIP-level) locationGet directions
Mailing address
5110 Misty Oaks Dr Apt 1813
Charlotte, NC 28269-4397
Registry dates
- Enumerated
- 2021-01-25
- Last updated
- 2021-01-25
- Certified
- 2021-01-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.