NURSE PRACTITIONER WOMEN'S HEALTH PLLC NPI 1568772952

NPI Information

NURSE PRACTITIONER WOMEN'S HEALTH, PLLC is a women's health nurse practitioner in Bronx, NY. NURSE PRACTITIONER WOMEN'S HEALTH, PLLC NPI is 1568772952. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Lifestyle Wellness Enterprise, Pllc.

The provider's business location address is:

140 DARROW PL
SUITE 16B
BRONX, NY
ZIP 10475-802
Phone: (718) 379-1290
Fax: (718) 379-8597

The provider's authorized official is Johnetta Miner .
The authorized official title is Ceo/president and has the following contact phone number 17183791290.

The enumeration date for this NPI number is 10/19/2010 and was last updated on 10/19/2010.

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:

Other Identifiers

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

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