=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043174212
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMBIENT WELL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/12/2025
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 24459 SUSSEX HWY
-----------------------------------------------------
City | SEAFORD
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19973-4433
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-629-3099
-----------------------------------------------------
Fax | 302-629-6059
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1827
-----------------------------------------------------
City | SEAFORD
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19973-8827
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-629-3099
-----------------------------------------------------
Fax | 302-629-6059
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | HELENE Y HENRY
-----------------------------------------------------
Credential | FNP-BC
-----------------------------------------------------
Telephone | 410-422-5066
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------