Healthcare Provider Details

I. General information

NPI: 1437906294
Provider Name (Legal Business Name): MORGAN ODUM FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2024
Last Update Date: 05/13/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 COUNTY COMPLEX RD STE 200
CLINTON NC
28328-4846
US

IV. Provider business mailing address

360 COUNTY COMPLEX RD STE 200
CLINTON NC
28328-4846
US

V. Phone/Fax

Practice location:
  • Phone: 910-592-1131
  • Fax: 910-592-4724
Mailing address:
  • Phone: 910-592-1131
  • Fax: 910-592-4724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5020389
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: