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General NPI Number Information
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NPI Number | 1588427652
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Entity Type | Organization
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Legal Business Name | LILLIES HOME HEALTH AND WELLNESS
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Dates
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Enumeration Date | 02/01/2024
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 2041 BONISLE CIR
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City | RIVIERA BEACH
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State | FL
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Zip | 33418-6504
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Country | US
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Telephone | 561-598-0446
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Fax | 561-258-0582
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Provider Business Mailing Address
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Address Line | 2041 BONISLE CIR
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City | RIVIERA BEACH
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State | FL
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Zip | 33418-6504
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Country | US
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Telephone | 561-598-0446
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Fax | 561-258-0582
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITIONER
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Name | MR. LILLIE MAE WHITEHURST
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Credential | ARNP
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Telephone | 561-598-0446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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