Healthcare Provider Details

I. General information

NPI: 1215818349
Provider Name (Legal Business Name): EVERNINE WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246C CHURCH ST NE
CONCORD NC
28025-4737
US

IV. Provider business mailing address

246C CHURCH ST NE
CONCORD NC
28025-4737
US

V. Phone/Fax

Practice location:
  • Phone: 704-706-9021
  • Fax:
Mailing address:
  • Phone: 704-251-5418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: CHARMARIA GURLEY
Title or Position: OWNER/CEO
Credential:
Phone: 704-251-5418