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General NPI Number Information
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NPI Number | 1356605646
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Entity Type | Individual
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Provider Name | JESSICA LYNNE MOREL D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 3615 DOVE MEADOW TRL
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-0057
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Country | US
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Telephone | 860-944-8908
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Fax |
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Provider Business Mailing Address
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Address Line | 3615 DOVE MEADOW TRL
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City | FAYETTEVILLE
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State | NC
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Zip | 28306-0057
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Country | US
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Telephone | 860-944-8908
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DO034563
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0102204772
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | OS017120
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2018-00048
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License Number State | NC
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