Individual provider Active NPI

Marjorie Ann Rea, WHNP

  • Women's Health Clinical Nurse Specialist
  • Benton Harbor, MI
National Provider Identifier
1588759690
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Clinical Nurse SpecialistTaxonomy code 364SW0102X
Practice address
769 Pipestone St
Benton Harbor, MI 49022-4815
Phone
(269) 684-2800
NPI assigned
Oct 4, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X MI
Women's Health Clinical Nurse Specialist 364SW0102X MI Primary

Addresses

Primary practice location

769 Pipestone St
Benton Harbor, MI 49022-4815

Mailing address

26777 Deerpath CT
Edwardsburg, MI 49112-8683
Phone (269) 663-8673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
REA1-0428-0515MIMDWomen's Health Clinical Nurse Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1588759690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26777 DEERPATH CT",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491128683",
            "telephone_number": "269-663-8673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 PIPESTONE ST",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490224815",
            "telephone_number": "269-684-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REA",
        "first_name": "MARJORIE",
        "middle_name": "ANN",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "364SW0102X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Women's Health",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton Harbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.