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NPI Code Detail

MEDICARE: NATURE BREAK WELLNESS LLC

MEDICARE: NATURE BREAK WELLNESS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251J00000XNursing Care Agency
2163WM1400XNurse Massage Therapist (NMT)
3261QH0100XHealth Service Clinic/Center
4363LF0000XFamily Nurse Practitioner

General Provider Information

NPI Number : 1144022658
Entity Type Code : Organization
Provider Name (Legal Business Name) : NATURE BREAK WELLNESS LLC
Provider Business Mailing Address
First Line : 35294 LOGAN LN
Second Line :
City : HILLMAN
State : MN
Zip : 56338-2445
Country : US
Telephone Number : 320-630-9116
Fax Number :
Provider Business Practice Location Address
First Line : 35294 LOGAN LN
Second Line :
City : HILLMAN
State : MN
Zip : 56338-2445
Country : US
Telephone Number : 320-630-9116
Fax Number :
Authorized Official
Title or Position : PRESIDENT/CEO
Name : LISA MARY GALL
Credential : NP
Telephone Number : 320-630-9116
Provider Enumeration Date : 03/25/2025
Last Update Date : 05/20/2025

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Directions to “NATURE BREAK WELLNESS LLC ” Practice Location

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