Healthcare Provider Details

I. General information

NPI: 1871312900
Provider Name (Legal Business Name): ANNABELLE FIELDS WELLNESS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 MARCUS NYAH CT
COLLEGE PARK GA
30349-4048
US

IV. Provider business mailing address

740 MARCUS NYAH CT
COLLEGE PARK GA
30349-4048
US

V. Phone/Fax

Practice location:
  • Phone: 513-704-4788
  • Fax:
Mailing address:
  • Phone: 513-704-4788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. JAIMEE KENYATTA COLVIN
Title or Position: CEO
Credential: APRN
Phone: 513-704-4788