Provider Demographics
NPI:1265112163
Name:HEATH, ANSLEY MORGAN (PA-C)
Entity type:Individual
Prefix:
First Name:ANSLEY
Middle Name:MORGAN
Last Name:HEATH
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 1:4501 WENCHELSEA PL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-3932
Mailing Address - Country:US
Mailing Address - Phone:919-608-1864
Mailing Address - Fax:
Practice Address - Street 1:3100 BLUE RIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-8002
Practice Address - Country:US
Practice Address - Phone:919-781-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical