Healthcare Provider Details

I. General information

NPI: 1083274575
Provider Name (Legal Business Name): MORGAN EDWARDS GIBBONS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN KELSEY EDWARDS PA-C

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 3RD AVE NE STE 500
HICKORY NC
28601-5055
US

IV. Provider business mailing address

1069 MAZEPPA RD
MOUNT ULLA NC
28125-9715
US

V. Phone/Fax

Practice location:
  • Phone: 828-304-6363
  • Fax:
Mailing address:
  • Phone: 704-657-5250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-09157
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: