Provider Demographics
NPI:1083251698
Name:MORSE, JACQUELINE ANN
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:ANN
Last Name:MORSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:ANN
Other - Last Name:MORSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JACQUELINE MORSE
Mailing Address - Street 1:208 COLEMAN ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-3767
Mailing Address - Country:US
Mailing Address - Phone:978-632-0934
Mailing Address - Fax:
Practice Address - Street 1:287 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-8311
Practice Address - Country:US
Practice Address - Phone:978-632-0934
Practice Address - Fax:888-607-9327
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker