Healthcare Provider Details

I. General information

NPI: 1013552256
Provider Name (Legal Business Name): MORGAN SUCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 12/29/2022
Certification Date: 12/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 STANTONSBURG RD
GREENVILLE NC
27834-2818
US

IV. Provider business mailing address

4949 HARBOUR TOWNE DR
RALEIGH NC
27604-5829
US

V. Phone/Fax

Practice location:
  • Phone: 252-816-3714
  • Fax:
Mailing address:
  • Phone: 919-323-0673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number287779
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number5017184
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: