MEDICARE: KATRINA MAE MORGAN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	6103	SC

General Provider Information

NPI Number	:	1760246375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRINA MAE MORGAN PA-C

Provider Business Mailing Address
First Line	:	808 MELROSE DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5507
Country	:	US
Telephone Number	:	304-617-0591
Fax Number	:

Provider Business Practice Location Address
First Line	:	808 MELROSE DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5507
Country	:	US
Telephone Number	:	304-617-0591
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2024
Last Update Date	:	01/16/2026

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