RENEW MENTAL HEALTH AND WELLNESS LLC NPI 1447817572

NPI Information

NPI: 1447817572
Provider Name: RENEW MENTAL HEALTH AND WELLNESS LLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

CLIA Number: 04D2222749

Address:
1150 E MATTHEWS AVE STE 101A
JONESBORO, AR
ZIP 72401
Phone: (870) 243-0424
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RENEW MENTAL HEALTH AND WELLNESS LLC is a psychiatric/mental health nurse practitioner in Jonesboro, AR. RENEW MENTAL HEALTH AND WELLNESS LLC NPI is 1447817572. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1150 E MATTHEWS AVE STE 101A
JONESBORO, AR
ZIP 72401-356
Phone: (870) 243-0424
Fax: (534) 248-4225

The provider's authorized official is Stacey Lynch .
The authorized official title is Owner and has the following contact phone number (870) 243-0424.

The CLIA number assigned to this NPI record is 04D2222749 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/23/2019 and was last updated on 9/28/2023.

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	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

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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