Provider Demographics
NPI:1073617577
Name:MORLEY, JULIE LOVE (PAC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LOVE
Last Name:MORLEY
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 FOX HOLLOW ROAD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374
Mailing Address - Country:US
Mailing Address - Phone:910-295-7546
Mailing Address - Fax:910-692-2831
Practice Address - Street 1:125 FOX HOLLOW ROAD
Practice Address - Street 2:SUITE 210
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374
Practice Address - Country:US
Practice Address - Phone:910-295-7546
Practice Address - Fax:910-692-2831
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102999363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2752898Medicare ID - Type Unspecified
P10445Medicare UPIN