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SOUTHERN MAGNOLIA HEALTH AND WELLNESS LLC NPI 1871108274


NPI Information

NPI: 1871108274
Provider Name: SOUTHERN MAGNOLIA HEALTH AND WELLNESS LLC
Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization

CLIA Number: 10D2233423

Address:
533 N NOVA RD STE 209
ORMOND BEACH, FL
ZIP 32174
Phone: (407) 590-0377
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SOUTHERN MAGNOLIA HEALTH AND WELLNESS LLC is a nurse practitioner in Ormond Beach, FL. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. SOUTHERN MAGNOLIA HEALTH AND WELLNESS LLC NPI is 1871108274. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

533 N NOVA RD STE 209
ORMOND BEACH, FL
ZIP 32174-422
Phone: (407) 590-0377

The provider's authorized official is Hope A King .
The authorized official title is Owner/aprn and has the following contact phone number (407) 590-0377.

The CLIA number assigned to this NPI record is 10D2233423 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/11/2020 and was last updated on 9/11/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse PractitionerYes

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

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