Healthcare Provider Details
I. General information
NPI: 1851086169
Provider Name (Legal Business Name): TOTAL INTEGRATED WOMEN'S HEALTH NP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/11/2023
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
180 S BROADWAY STE 210
WHITE PLAINS NY
10605-1820
US
IV. Provider business mailing address
180 S BROADWAY STE 210
WHITE PLAINS NY
10605-1820
US
V. Phone/Fax
- Phone: 914-574-4535
- Fax: 914-574-4535
- Phone: 914-574-4535
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
R
WALSH
Title or Position: OWNER, NURSE PRACTITIONER
Credential: APN
Phone: 914-574-4535