Provider Demographics
NPI:1083274575
Name:EDWARDS, MORGAN KELSEY (PA-C)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:KELSEY
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 MAZEPPA RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT ULLA
Mailing Address - State:NC
Mailing Address - Zip Code:28125-9715
Mailing Address - Country:US
Mailing Address - Phone:704-657-5250
Mailing Address - Fax:
Practice Address - Street 1:10 3RD AVE NE STE 500
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5055
Practice Address - Country:US
Practice Address - Phone:828-304-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NC0010-09157363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant