Provider Demographics
NPI:1497423776
Name:KESSEL, JACQUELYN MARIE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELYN
Middle Name:MARIE
Last Name:KESSEL
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LOVE MEMORIAL CLINIC
Mailing Address - Street 2:112 KUYKERDALL LANE
Mailing Address - City:MOOREFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:26836-1167
Mailing Address - Country:US
Mailing Address - Phone:305-530-7755
Mailing Address - Fax:304-530-7756
Practice Address - Street 1:LOVE MEMORIAL CLINIC
Practice Address - Street 2:112 KUYKERDALL LANE
Practice Address - City:MOOREFIELD
Practice Address - State:WV
Practice Address - Zip Code:26836-1167
Practice Address - Country:US
Practice Address - Phone:305-530-7755
Practice Address - Fax:304-530-7756
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV110096363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner