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General NPI Number Information
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NPI Number | 1265254387
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Entity Type | Organization
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Legal Business Name | SIMPLY LAVISH HEALTH AND WELLNESS ANP-C NURSING CORP
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1137 N CENTRAL AVE APT 313
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City | GLENDALE
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State | CA
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Zip | 91202-3670
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Country | US
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Telephone | 314-873-4485
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Fax | 818-230-2670
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Provider Business Mailing Address
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Address Line | 1137 N CENTRAL AVE APT 313
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City | GLENDALE
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State | CA
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Zip | 91202-3670
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Country | US
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Telephone | 314-873-4485
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Fax | 818-230-2670
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Authorized Official
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Title or Position | CEO/NURSE PRACTITIONER
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Name | JENNY LYNETTE BROWN
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Credential | NURSE PRACTITIONER
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Telephone | 314-873-4485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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