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General NPI Number Information
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NPI Number | 1609389337
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Entity Type | Organization
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Legal Business Name | HEATH HEALTH AND WELLNESS
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Dates
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Enumeration Date | 11/16/2017
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 9275 BAY POINT DR
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City | ELBERTA
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State | AL
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Zip | 36530-6561
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Country | US
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Telephone | 205-401-0976
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Fax |
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Provider Business Mailing Address
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Address Line | 24750 STATE ST UNIT 695
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City | ELBERTA
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State | AL
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Zip | 36530-2024
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Country | US
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Telephone | 205-401-0976
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DONNA SUSANNE HEATH
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Credential | CRNP
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Telephone | 205-401-0976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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