Healthcare Provider Details

I. General information

NPI: 1730179938
Provider Name (Legal Business Name): ELIZABETH MORGAN KACZOR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH ANN MORGAN PA-C

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4904 PROFESSIONAL CT
RALEIGH NC
27609-4969
US

IV. Provider business mailing address

3225 DONLIN DR
WAKE FOREST NC
27587-5481
US

V. Phone/Fax

Practice location:
  • Phone: 919-893-4465
  • Fax: 800-860-8126
Mailing address:
  • Phone: 919-889-2557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0810X
TaxonomyChild & Family Psychiatric/Mental Health Clinical Nurse Specialist
License Number103112
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number103112
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number103112
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: