=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013644202
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAPID ACCESS WELLNESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2022
-----------------------------------------------------
Last Update Date | 08/25/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9683 IBIS GROVE BLVD
-----------------------------------------------------
City | WESLEY CHAPEL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33545-2279
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-344-5596
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9683 IBIS GROVE BLVD
-----------------------------------------------------
City | WESLEY CHAPEL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33545-2279
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-344-5596
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER/PROVIDER
-----------------------------------------------------
Name | JILL M HUNTZINGER
-----------------------------------------------------
Credential | NP-C
-----------------------------------------------------
Telephone | 813-344-5596
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------