INTENTIONAL WELLNESS MEDSPA LLC NPI 1154088052

NPI Information

  • NPI: 1154088052
  • Provider Name: INTENTIONAL WELLNESS MEDSPA LLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • :
  • Address: 99 CAMBRIDGE ST
    BURLINGTON, MA
    ZIP 01803
  • Phone: (781) 552-8438

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NPI Details

INTENTIONAL WELLNESS MEDSPA LLC is a family nurse practitioner in Burlington, MA. INTENTIONAL WELLNESS MEDSPA LLC NPI is 1154088052. The provider is registered as an organization entity type and is a single specialty group.
The provider .

The provider's business location address is:

99 CAMBRIDGE ST
BURLINGTON, MA
ZIP 01803-115
Phone: (781) 552-8438

The provider's authorized official is La-keisha Renee Milord .
The authorized official title is Ceo and has the following contact phone number (781) 552-8438.

The enumeration date for this NPI number is 11/26/2021 and was last updated on 2/9/2025.

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
1363LF0000XNurse PractitionerFamilyYes

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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