Healthcare Provider Details

I. General information

NPI: 1205717501
Provider Name (Legal Business Name): MIXERUP EVENTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

25 HOMESTEAD CIR
MILFORD NH
03055-4251
US

IV. Provider business mailing address

25 HOMESTEAD CIR
MILFORD NH
03055-4251
US

V. Phone/Fax

Practice location:
  • Phone: 603-440-0533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIZABETH LANG
Title or Position: HEALTH & WELLNESS COACH
Credential: NBHWC
Phone: 603-440-0533