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General NPI Number Information
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NPI Number | 1336924042
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Entity Type | Organization
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Legal Business Name | POSITIVE HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 08/30/2023
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 83313 508TH AVE
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City | BARTLETT
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State | NE
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Zip | 68622-3042
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Country | US
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Telephone | 402-660-4897
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Fax |
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Provider Business Mailing Address
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Address Line | 83313 508TH AVE
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City | BARTLETT
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State | NE
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Zip | 68622-3042
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Country | US
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Telephone | 402-660-4897
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Fax | 402-769-3876
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | JENNIFER DWYER
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Credential | NP-C
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Telephone | 402-660-4897
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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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