BLUE MOUNTAIN WELLNESS PLLC NPI 1477113637

NPI Information

NPI: 1477113637
Provider Name: BLUE MOUNTAIN WELLNESS, PLLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
517 N BROAD ST
LANSDALE, PA
ZIP 19446
Phone: (215) 647-2175
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BLUE MOUNTAIN WELLNESS, PLLC is a psychiatric/mental health nurse practitioner in Lansdale, PA. BLUE MOUNTAIN WELLNESS, PLLC NPI is 1477113637. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

517 N BROAD ST
LANSDALE, PA
ZIP 19446-415
Phone: (215) 647-2175

The provider's authorized official is Lucille Constantine .
The authorized official title is Owner and has the following contact phone number (215) 647-2175.

The enumeration date for this NPI number is 6/19/2019 and was last updated on 1/11/2023.

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

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1194082347	OTHER	PENNSYLVANIA	INDIVIDUAL NPI
2	1037502590001	MEDICAID	PENNSYLVANIA

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: 5/5/2024

NPI Synchronization or Removal

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