Healthcare Provider Details

I. General information

NPI: 1710663869
Provider Name (Legal Business Name): POSITIVE VIBES VENTURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20214 ANDORRA POINTE TRCE
RICHMOND TX
77407-2330
US

IV. Provider business mailing address

20214 ANDORRA POINTE TRCE
RICHMOND TX
77407-2330
US

V. Phone/Fax

Practice location:
  • Phone: 832-403-0352
  • Fax:
Mailing address:
  • Phone: 832-403-0352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code364SH0200X
TaxonomyHome Health Clinical Nurse Specialist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code364SL0600X
TaxonomyLong-Term Care Clinical Nurse Specialist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code364SX0106X
TaxonomyOccupational Health Clinical Nurse Specialist
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARIONNE RAYNER
Title or Position: MANAGING MEMBER
Credential: FNP
Phone: 832-403-0352