EASY CARE WELLNESS LLC NPI 1417751306

NPI Information

  • NPI: 1417751306
  • Provider Name: EASY CARE WELLNESS LLC
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 11D2323791
  • Address: 1050 BARBER CREEK DR BLDG 100
    STE 103
    WATKINSVILLE, GA
    ZIP 30677
  • Phone: (706) 850-0170

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NPI Details

EASY CARE WELLNESS LLC is a primary care nurse practitioner in Watkinsville, GA. EASY CARE WELLNESS LLC NPI is 1417751306. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1050 BARBER CREEK DR BLDG 100
STE 103
WATKINSVILLE, GA
ZIP 30677-502
Phone: (706) 850-0170
Fax: (888) 355-5361

The provider's authorized official is Chaquita Thomas .
The authorized official title is Owner and has the following contact phone number (334) 380-1888.

The CLIA number assigned to this NPI record is 11D2323791 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/1/2025 and was last updated on 5/21/2025.

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
1363LP2300XNurse PractitionerPrimary CareYes

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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