Healthcare Provider Details

I. General information

NPI: 1619552247
Provider Name (Legal Business Name): JESSICA RAQUEL MORWAY AGACNP-BC, RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2021
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10210 N 92ND ST STE 300
SCOTTSDALE AZ
85258-4525
US

IV. Provider business mailing address

10210 N 92ND ST STE 300
SCOTTSDALE AZ
85258-4525
US

V. Phone/Fax

Practice location:
  • Phone: 480-882-7750
  • Fax:
Mailing address:
  • Phone: 480-882-7750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN212861
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number307950
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: