Healthcare Provider Details

I. General information

NPI: 1598499485
Provider Name (Legal Business Name): MORGAN BOYD STAHL PA-C, RN, BSN CNOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2022
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 STANTONSBURG RD
GREENVILLE NC
27834-2818
US

IV. Provider business mailing address

210 TURNER RUN DR
GREENVILLE NC
27858-7416
US

V. Phone/Fax

Practice location:
  • Phone: 252-943-4368
  • Fax:
Mailing address:
  • Phone: 252-943-4368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number0010-13837
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: