| NPI | 1770237976 |
|---|---|
| Other Name | MISTY REAGAN |
| Entity Type | Organization |
| Authorized Contact | MISTY REAGAN Provider 336-908-2326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2022-02-07 |