Provider Demographics
NPI:1356605646
Name:MOREL, JESSICA LYNNE (DO)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNNE
Last Name:MOREL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 DOVE MEADOW TRL
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-0057
Mailing Address - Country:US
Mailing Address - Phone:860-944-8908
Mailing Address - Fax:
Practice Address - Street 1:3615 DOVE MEADOW TRL
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-0057
Practice Address - Country:US
Practice Address - Phone:860-944-8908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDO0345632084P0800X
VA01022047722084P0800X
PAOS0171202084P0800X
NC2018-000482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry