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General NPI Number Information
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NPI Number | 1205459161
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Entity Type | Organization
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Legal Business Name | NOUVEAUX U WELLNESS PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 2675 MALL OF GEORGIA BLVD STE 103
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City | BUFORD
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State | GA
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Zip | 30519-8783
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Country | US
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Telephone | 678-979-3905
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Fax |
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Provider Business Mailing Address
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Address Line | 2675 MALL OF GEORGIA BLVD STE 103
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City | BUFORD
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State | GA
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Zip | 30519-8783
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Country | US
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Telephone | 678-979-3905
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MRS. MELISSA ROMULUS PAULINE
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Credential | NP
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Telephone | 678-979-3905
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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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