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General NPI Number Information
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NPI Number | 1194180703
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Entity Type | Organization
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Legal Business Name | YOUR HEALTH NURSE PRACTITIONER
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Dates
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Enumeration Date | 12/24/2015
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Last Update Date | 12/24/2015
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Provider Practice Location Address
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Address Line | 2060 GREENVIEW SHORES BLVD APT 315
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City | WELLINGTON
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State | FL
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Zip | 33414-2731
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Country | US
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Telephone | 561-452-8563
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Fax | 561-318-6885
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Provider Business Mailing Address
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Address Line | 2060 GREENVIEW SHORES BLVD APT 315
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City | WELLINGTON
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State | FL
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Zip | 33414-2731
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Country | US
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Telephone | 561-452-8563
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Fax | 561-318-6885
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Authorized Official
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Title or Position | AUTHORIZED MEMBER
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Name | LYNDA GERMEIL BALDEOSINGH
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Credential | ARNP
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Telephone | 561-318-6885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 9182389
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License Number State | FL
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