Basic Information
| Provider Information | |||||||||
| NPI: | 1427030014 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORELLE | ||||||||
| FirstName: | LEA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 BALDWIN AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282043227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043849113 | ||||||||
| FaxNumber: | 7043849118 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 N TRYON ST | ||||||||
| Address2: | #75 | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282024000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043847085 | ||||||||
| FaxNumber: | 7043847089 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 00436 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.