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General NPI Number Information
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NPI Number | 1346962248
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Entity Type | Organization
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Legal Business Name | APPLING TOTAL WELLNESS, LLC
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Dates
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Enumeration Date | 09/16/2022
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 1745 CITY CIRCLE RD BLDG B
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City | BAXLEY
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State | GA
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Zip | 31513-7059
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Country | US
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Telephone | 912-705-1939
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Fax |
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Provider Business Mailing Address
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Address Line | 1745 CITY CIRCLE RD BLDG B
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City | BAXLEY
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State | GA
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Zip | 31513-7059
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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 | FNP-BC
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Name | MRS. AMANDA NICOLE DEEN
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Credential | MSN, FNP-BC
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Telephone | 912-387-5557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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