=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215609748
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WELLNESS & BALANCE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2021
-----------------------------------------------------
Last Update Date | 05/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3101 AMERICAN LEGION RD STE 12
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23321-5655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-469-1452
-----------------------------------------------------
Fax | 757-956-5073
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3101 AMERICAN LEGION RD STE 12
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23321-5655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-469-1452
-----------------------------------------------------
Fax | 757-956-5073
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PROVIDER
-----------------------------------------------------
Name | MRS. ANGEL MARIE WILLIAMS-KENT
-----------------------------------------------------
Credential | NP-C
-----------------------------------------------------
Telephone | 757-324-1312
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------