Individual
MRS. LECIA WOOTEN REARDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
340 SEMINARY ST, KENANSVILLE, NC 28349-8978
(910) 296-2130
(910) 296-0252
Mailing address
340 SEMINARY ST, KENANSVILLE, NC 28349-8978
(910) 296-2130
(910) 296-0252
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
201848
NC
363LF0000X
Family Nurse Practitioner
Primary
201848
NC
Other
Enumeration date
01/04/2007
Last updated
09/11/2019
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