MEDICARE: MRS. ANNA BROOKS MANESS REED NP

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
1	363L00000X	Nurse Practitioner	5012358	NC

General Provider Information

NPI Number	:	1336781715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNA BROOKS MANESS REED NP

Provider Business Mailing Address
First Line	:	1351 ELEMENT WAY APT 5202
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-1621
Country	:	US
Telephone Number	:	513-300-3773
Fax Number	:

Provider Business Practice Location Address
First Line	:	2053 VALLEYGATE DR STE 102
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-3983
Country	:	US
Telephone Number	:	910-323-3757
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2019
Last Update Date	:	10/17/2019

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