Healthcare Provider Details

I. General information

NPI: 1760004899
Provider Name (Legal Business Name): AMARNA NUTRITION & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5835 CALLAGHAN RD STE 205
SAN ANTONIO TX
78228-1224
US

IV. Provider business mailing address

5835 CALLAGHAN RD STE 205
SAN ANTONIO TX
78228-1224
US

V. Phone/Fax

Practice location:
  • Phone: 210-519-6039
  • Fax:
Mailing address:
  • Phone: 210-519-6039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name: NINA CARR
Title or Position: CEO
Credential:
Phone: 210-473-7795