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General NPI Number Information
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NPI Number | 1073484564
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Entity Type | Organization
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Legal Business Name | PURPOSEFUL HEALING LLC
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 305 KAYDEN CV
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City | LAKE WALES
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State | FL
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Zip | 33859-8249
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Country | US
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Telephone | 863-241-8447
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Fax |
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Provider Business Mailing Address
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Address Line | 305 KAYDEN CV
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City | LAKE WALES
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State | FL
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Zip | 33859-8249
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Country | US
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Telephone | 863-241-8447
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DESHAWN DELORIS MITCHELL
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Credential | ARNP
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Telephone | 863-241-8447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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