Healthcare Provider Details

I. General information

NPI: 1114144524
Provider Name (Legal Business Name): HOMEBORN HEALTH, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 05/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 SNELSON DR
ASHEVILLE NC
28806-7416
US

IV. Provider business mailing address

24 SNELSON DR
ASHEVILLE NC
28806-7416
US

V. Phone/Fax

Practice location:
  • Phone: 828-515-5227
  • Fax: 828-515-5227
Mailing address:
  • Phone: 828-515-5227
  • Fax: 828-515-5227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number209-003484
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number209-003485
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number634
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number286113
License Number StateNC

VIII. Authorized Official

Name: MRS. JUDITH CAROL WRZESINSKI
Title or Position: PRESIDENT
Credential: CERTIFIED NURSE - MI
Phone: 815-218-0766