Provider Demographics
NPI:1598551145
Name:REEVES, CARLY MORGAN (DNP, APRN, CPNP-PC)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:MORGAN
Last Name:REEVES
Suffix:
Gender:
Credentials:DNP, APRN, CPNP-PC
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:MORGAN
Other - Last Name:REEVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, APRN, CPNP-PC
Mailing Address - Street 1:4915 W IDAHO ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33616-2803
Mailing Address - Country:US
Mailing Address - Phone:904-894-5972
Mailing Address - Fax:
Practice Address - Street 1:4444 E FLETCHER AVE STE C
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4905
Practice Address - Country:US
Practice Address - Phone:813-903-0060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11037326363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics