Healthcare Provider Details

I. General information

NPI: 1619886843
Provider Name (Legal Business Name): MYLUMA HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/14/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 PARK RD STE 2B
PLEASANT GROVE AL
35127
US

IV. Provider business mailing address

47 PARK RD STE 2B
PLEASANT GROVE AL
35127
US

V. Phone/Fax

Practice location:
  • Phone: 727-390-4594
  • Fax:
Mailing address:
  • Phone: 727-390-4594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: EMMA MWANGI
Title or Position: OWNER
Credential:
Phone: 727-390-4594