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General NPI Number Information
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NPI Number | 1487315131
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Entity Type | Organization
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Legal Business Name | FIRE WEIGHT LOSS AND WELLNESS OF NYC
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Dates
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Enumeration Date | 01/05/2022
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 1151 N BUCKNER BLVD STE 407
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City | DALLAS
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State | TX
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Zip | 75218-3407
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Country | US
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Telephone | 972-729-9010
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Fax | 469-947-6767
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Provider Business Mailing Address
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Address Line | 1617 BEAUREGARD POINT DR
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City | WYLIE
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State | TX
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Zip | 75098-8509
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Country | US
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Telephone | 972-729-9010
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Fax | 469-947-6767
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Authorized Official
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Title or Position | OWNER OF ENTITY
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Name | NADIA C POWELL
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Credential | APRN, PMHNP-BC, FNP-
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Telephone | 972-729-9010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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