Provider Demographics
NPI:1821806803
Name:MCVICKER, MORGAN ELIZABETH (PA-C)
Entity type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:ELIZABETH
Last Name:MCVICKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 LINING LN
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7710
Mailing Address - Country:US
Mailing Address - Phone:847-404-9207
Mailing Address - Fax:
Practice Address - Street 1:1113 LINING LN
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7710
Practice Address - Country:US
Practice Address - Phone:847-404-9207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health