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General NPI Number Information
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NPI Number | 1497629356
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Entity Type | Organization
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Legal Business Name | VELLURA HEALTH LLC
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 5483 N BLACK SAND AVE
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City | MERIDIAN
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State | ID
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Zip | 83646-5662
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Country | US
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Telephone | 509-251-8920
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Fax | 208-264-9569
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Provider Business Mailing Address
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Address Line | 6700 N LINDER RD STE 156A
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City | MERIDIAN
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State | ID
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Zip | 83646-6607
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Country | US
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Telephone | 509-251-8920
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Fax | 208-264-9569
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Authorized Official
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Title or Position | OWNER/ NURSE PRACTITIONER
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Name | TAYLOR RENAE GARCIA
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Credential | APRN
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Telephone | 509-251-8920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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