Provider Demographics
NPI:1336781715
Name:REED, ANNA BROOKS MANESS (NP)
Entity Type:Individual
Prefix:MRS
First Name:ANNA BROOKS
Middle Name:MANESS
Last Name:REED
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 ELEMENT WAY APT 5202
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-1621
Mailing Address - Country:US
Mailing Address - Phone:513-300-3773
Mailing Address - Fax:
Practice Address - Street 1:2053 VALLEYGATE DR STE 102
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3983
Practice Address - Country:US
Practice Address - Phone:910-323-3757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012358363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner