LOGAN WELLNESS ADVANCED NURSING PRACTICE CORP NPI 1245870799

NPI Information

NPI: 1245870799
Provider Name: LOGAN WELLNESS ADVANCED NURSING PRACTICE CORP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
655 N CENTRAL AVE # 1754
GLENDALE, CA
ZIP 91203
Phone: (310) 751-1080
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LOGAN WELLNESS ADVANCED NURSING PRACTICE CORP is a psychiatric/mental health nurse practitioner in Glendale, CA. LOGAN WELLNESS ADVANCED NURSING PRACTICE CORP NPI is 1245870799. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

655 N CENTRAL AVE # 1754
GLENDALE, CA
ZIP 91203-422
Phone: (310) 751-1080
Fax: (844) 941-1989

The provider's authorized official is Mark Logan .
The authorized official title is President and has the following contact phone number (310) 751-1080.

The enumeration date for this NPI number is 1/13/2020 and was last updated on 2/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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