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General NPI Number Information
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NPI Number | 1184238685
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Entity Type | Organization
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Legal Business Name | ESSENTIAL HEALTH & WELLNESS
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Dates
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Enumeration Date | 09/02/2020
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 616 EDGEFIELD RD UNIT 170
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841
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Country | US
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Telephone | 225-284-8197
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Fax |
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Provider Business Mailing Address
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Address Line | 616 EDGEFIELD RD STE 170
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City | NORTH AUGUSTA
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State | SC
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Zip | 29841-6407
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Country | US
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Telephone | 803-282-9481
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Fax | 803-675-7611
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Authorized Official
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Title or Position | OWNER
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Name | ANGELA E DYKES
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Credential | DNP, APRN, FNP-BC
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Telephone | 803-282-9481
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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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