DIABETES WELLNESS NP PLLC NPI 1083296057

NPI Information

  • NPI: 1083296057
  • Provider Name: DIABETES WELLNESS NP, PLLC
  • Classification: Clinic/Center - 261QC1500X
  • Specialization: Community Health
  • Entity Type: Organization
  • CLIA Number: 04D2254924
  • Address: 700 N MISSOURI ST STE 2
    WEST MEMPHIS, AR
    ZIP 72301
  • Phone: (870) 551-4409

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NPI Details

DIABETES WELLNESS NP, PLLC is a community health clinic center in West Memphis, AR. DIABETES WELLNESS NP, PLLC NPI is 1083296057. The provider is registered as an organization entity type.

The provider's business location address is:

700 N MISSOURI ST STE 2
WEST MEMPHIS, AR
ZIP 72301-150
Phone: (870) 551-4409

The provider's authorized official is Nykkia Sellers .
The authorized official title is President/owner and has the following contact phone number (901) 249-0755.

The CLIA number assigned to this NPI record is 04D2254924 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/28/2021 and was last updated on 11/30/2022.

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
1261QC1500XClinic/CenterCommunity HealthYes

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: 11/21/2025

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