Provider Demographics
NPI:1245779826
Name:MORGAN, KATHERINE (PT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5505 CREEDMOOR RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-6352
Mailing Address - Country:US
Mailing Address - Phone:919-785-9090
Mailing Address - Fax:919-785-2984
Practice Address - Street 1:5505 CREEDMOOR RD
Practice Address - Street 2:SUITE 205
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-6352
Practice Address - Country:US
Practice Address - Phone:919-785-9090
Practice Address - Fax:919-785-2984
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP3267251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC231943113Medicare PIN