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General NPI Number Information
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NPI Number | 1144813411
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Entity Type | Organization
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Legal Business Name | HOMEBOUND HEALTH AND WELLNESS, LLC
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Dates
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Enumeration Date | 02/17/2021
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 950 EAGLES LANDING PKWY STE 681
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7343
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Country | US
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Telephone | 678-516-4022
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Fax |
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Provider Business Mailing Address
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Address Line | 950 EAGLES LANDING PKWY PO BOX 681
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-0681
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Country | US
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Telephone | 678-516-4022
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | JANISE ROEBUCK
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Credential | FNP-C
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Telephone | 678-516-4022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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