BUILD AND RESTORE LLC NPI 1225616618

NPI Information

  • NPI: 1225616618
  • Provider Name: BUILD AND RESTORE, LLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • :
  • CLIA Number: 11D2237236
  • Address: 2211 BARTOW ST
    BRUNSWICK, GA
    ZIP 31520
  • Phone: (850) 210-2473

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NPI Details

BUILD AND RESTORE, LLC is a family nurse practitioner in Brunswick, GA. BUILD AND RESTORE, LLC NPI is 1225616618. The provider is registered as an organization entity type and is a single specialty group.
The provider .

The provider's business location address is:

2211 BARTOW ST
BRUNSWICK, GA
ZIP 31520-604
Phone: (850) 210-2473

The provider's authorized official is Gwendolyn Flonnery-roberts .
The authorized official title is Owner/nurse Practitioner and has the following contact phone number (912) 209-5444.

The CLIA number assigned to this NPI record is 11D2237236 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/29/2021 and was last updated on 4/17/2025.

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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