Healthcare Provider Details

I. General information

NPI: 1093597262
Provider Name (Legal Business Name): HOMETOWN WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2023
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 NE PARK ST
OKEECHOBEE FL
34972-2923
US

IV. Provider business mailing address

2201 SW 28TH ST # VILLA84
OKEECHOBEE FL
34974-5703
US

V. Phone/Fax

Practice location:
  • Phone: 863-484-6020
  • Fax: 863-484-6017
Mailing address:
  • Phone: 863-634-4218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. TAMMY THERESA HEDRICK
Title or Position: APRN
Credential: APRN
Phone: 863-634-4218