Healthcare Provider Details

I. General information

NPI: 1568135697
Provider Name (Legal Business Name): KASEY LYNN MORRIS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3480 WAKE FOREST RD STE 310
RALEIGH NC
27609-7376
US

IV. Provider business mailing address

3480 WAKE FOREST RD STE 310
RALEIGH NC
27609-7376
US

V. Phone/Fax

Practice location:
  • Phone: 919-862-5650
  • Fax: 919-862-2677
Mailing address:
  • Phone: 919-862-5650
  • Fax: 919-862-2677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number0010-12828
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: