Healthcare Provider Details

I. General information

NPI: 1164061404
Provider Name (Legal Business Name): CHRISTOPHER RYAN REECE FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2020
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5112 N CROATAN HWY
KITTY HAWK NC
27949-3988
US

IV. Provider business mailing address

101 HEART DR
GREENVILLE NC
27834-8982
US

V. Phone/Fax

Practice location:
  • Phone: 252-449-7474
  • Fax:
Mailing address:
  • Phone: 252-449-7474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5018098
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: