Healthcare Provider Details

I. General information

NPI: 1447190020
Provider Name (Legal Business Name): VIRTUAL WELLNESS CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W GREENLAWN AVE STE G11
LANSING MI
48910-2889
US

IV. Provider business mailing address

31355 BRETZ DR
WARREN MI
48093-5532
US

V. Phone/Fax

Practice location:
  • Phone: 313-346-4240
  • Fax: 313-346-4241
Mailing address:
  • Phone: 313-346-4240
  • Fax: 313-346-4241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: TYNISE PENN
Title or Position: OWNER
Credential: DNP
Phone: 313-350-1657