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General NPI Number Information
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NPI Number | 1124837711
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Entity Type | Individual
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Provider Name | MORGANNE LEIGH REYES FNP
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Gender | Female
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 630 N FODALE AVE
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City | SOUTHPORT
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State | NC
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Zip | 28461-3538
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Country | US
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Telephone | 910-457-9581
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Fax |
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Provider Business Mailing Address
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Address Line | 8636 PLANTATION LANDING DR
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City | WILMINGTON
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State | NC
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Zip | 28411-8925
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Country | US
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Telephone | 419-270-2054
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 367184
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5021562
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License Number State | NC
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