Provider Demographics
NPI:1619359338
Name:STORER, JESSICA LINIECE (FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:LINIECE
Last Name:STORER
Suffix:
Gender:F
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:NEWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28657-0002
Mailing Address - Country:US
Mailing Address - Phone:828-397-9334
Mailing Address - Fax:828-373-9218
Practice Address - Street 1:137 NOTALEE ST
Practice Address - Street 2:
Practice Address - City:NEWLAND
Practice Address - State:NC
Practice Address - Zip Code:28657-9573
Practice Address - Country:US
Practice Address - Phone:828-397-9334
Practice Address - Fax:828-373-9218
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007700363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health