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General NPI Number Information
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NPI Number | 1508550583
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Entity Type | Organization
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Legal Business Name | WELLNESS CARE SERVICES LLC
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 12/27/2023
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Provider Practice Location Address
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Address Line | 11041 HENSELL RD
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City | HOLLY
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State | MI
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Zip | 48442-8054
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Country | US
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Telephone | 810-656-2208
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Fax | 810-545-4196
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Provider Business Mailing Address
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Address Line | 11041 HENSELL RD
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City | HOLLY
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State | MI
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Zip | 48442-8054
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Country | US
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Telephone | 810-656-2208
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Fax |
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Authorized Official
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Title or Position | NP/OWNER
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Name | ANGELA MARIE HANNA
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Credential | AGACNP
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Telephone | 810-656-2208
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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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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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