Provider Demographics
NPI:1588348148
Name:MORRISSEY, JERILYN PAT (MD)
Entity type:Individual
Prefix:DR
First Name:JERILYN
Middle Name:PAT
Last Name:MORRISSEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15851 N COUNTY ROAD 7
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:CO
Mailing Address - Zip Code:80549-2107
Mailing Address - Country:US
Mailing Address - Phone:630-253-5425
Mailing Address - Fax:
Practice Address - Street 1:17 CAMPUS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3257
Practice Address - Country:US
Practice Address - Phone:720-402-0998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC54400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics