Healthcare Provider Details

I. General information

NPI: 1689137507
Provider Name (Legal Business Name): WELLNESS OPTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 04/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 BARBARA LOOP SE STE B
RIO RANCHO NM
87124-1011
US

IV. Provider business mailing address

4101 BARBARA LOOP SE STE B
RIO RANCHO NM
87124-1011
US

V. Phone/Fax

Practice location:
  • Phone: 505-553-4014
  • Fax: 505-898-1559
Mailing address:
  • Phone: 505-553-4014
  • Fax: 505-898-1559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: WENDEE KAY BURNETT
Title or Position: CFNP,BC
Credential: CFNP,BC
Phone: 505-553-4014