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General NPI Number Information
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NPI Number | 1215876230
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Entity Type | Organization
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Legal Business Name | ELEVATEDWELLCARELLC
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 23204 131ST AVE
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City | LAURELTON
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State | NY
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Zip | 11413-1811
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Country | US
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Telephone | 347-733-0643
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Fax |
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Provider Business Mailing Address
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Address Line | 23204 131ST AVE
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City | SPRINGFIELD GARDENS
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State | NY
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Zip | 11413-1811
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE SADLER
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Credential | DNP,FNP-BC
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Telephone | 347-733-0643
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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 |
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License Number State |
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