The accident happened around 6 a.m. Pictures from Chopper 11 HD showed a vehicle pinned underneath a tractor-trailer.
Troopers said the truck - hauling trees - was backing up to make a delivery when a Honda Odyssey headed southbound hit the big rig.
The woman driving the van was trapped in the wreckage for a time. She was flown to WakeMed, where she was listed in good condition.
The driver of the truck has been charged with a yield violation.