HOLISTIC WELLNESS GROUP LLC NPI 1891369823

NPI Information

NPI: 1891369823
Provider Name: HOLISTIC WELLNESS GROUP, LLC

Former Legal Business Name: HOLISTIC WELLNESS GROUP, LLC

Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
808 LAY DAM RD
CLANTON, AL
ZIP 35045
Phone: (205) 369-1273
Get Directions

HOLISTIC WELLNESS GROUP, LLC is a psychiatric/mental health nurse practitioner in Clanton, AL. HOLISTIC WELLNESS GROUP, LLC NPI is 1891369823. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Holistic Wellness Group, Llc.

The provider's business location address is:

808 LAY DAM RD
CLANTON, AL
ZIP 35045-943
Phone: (205) 369-1273
Fax: (205) 369-1273

The provider's authorized official is Melissa Ashley .
The authorized official title is Prescriber/member and has the following contact phone number (205) 430-9966.

The enumeration date for this NPI number is 5/14/2021 and was last updated on 12/31/2021.

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	363LF0000X	Nurse Practitioner	Family			No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	270189	MEDICAID	ALABAMA

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: 4/28/2024

NPI Synchronization or Removal

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