Individual
EDNA KABISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3542
Mailing address
5221 PARAMOUNT PKWY, STE 420, MORRISVILLE, NC 27560-5491
(984) 974-1256
(984) 974-1316
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-13397
NC
363AM0700X
Medical Physician Assistant
0010-13397
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689455230
—
NC
Enumeration date
10/10/2023
Last updated
06/17/2025
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