Healthcare Provider Details

I. General information

NPI: 1821937335
Provider Name (Legal Business Name): JESSI MORA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 N 17TH AVE
GREELEY CO
80631-9117
US

IV. Provider business mailing address

203 N 51ST AVE
GREELEY CO
80634-4266
US

V. Phone/Fax

Practice location:
  • Phone: 970-400-6410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1700134
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: