Healthcare Provider Details

I. General information

NPI: 1174065106
Provider Name (Legal Business Name): SHARON D MORGAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2016
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4551 NEW BERN AVE STE 160
RALEIGH NC
27610-1552
US

IV. Provider business mailing address

4551 NEW BERN AVE STE 160
RALEIGH NC
27610-1552
US

V. Phone/Fax

Practice location:
  • Phone: 919-556-1008
  • Fax: 919-556-6099
Mailing address:
  • Phone: 919-556-1008
  • Fax: 919-556-6099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5009085
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number5009085
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5009085
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: