MEDICARE: MORGAN DEER FNP

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	363LF0000X	Family Nurse Practitioner	319090	NC

General Provider Information

NPI Number	:	1548142888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN DEER FNP

Provider Business Mailing Address
First Line	:	333 W TRADE ST UNIT 1709
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28202-1953
Country	:	US
Telephone Number	:	304-610-7141
Fax Number	:

Provider Business Practice Location Address
First Line	:	1819 CLEVELAND AVE UNIT B1
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-4701
Country	:	US
Telephone Number	:	704-299-1301
Fax Number	:

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

Provider Enumeration Date	:	07/25/2025
Last Update Date	:	07/28/2025

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