Doctor Name: | JESSICA LAUREN DEL VECCHIO |
NPI Number: | 1003220518 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 268791 |
Business Practice Address: | 1021 Morehead Medical Dr Suite A Charlotte, NC - 282042990 |
Business Phone Number: | 9804422000 |
Business Fax Number: | 7043555800 |
Mailing Address: | Po Box 602120, CHARLOTTE |
State: | NC |
Postal Code: | 282602120 |
Phone Number: | 9804422000 |
Fax Number: | 7043555800 |
NPI Enumeration Date: | 06/12/2014 |
NPI Last Update Date: | 12/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 268791 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |