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General NPI Number Information
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NPI Number | 1629885082
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Entity Type | Organization
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Legal Business Name | INTEGRATED HEALTH, LLC
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 291 CARTER DR STE B
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City | MIDDLETOWN
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State | DE
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Zip | 19709-5845
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Country | US
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Telephone | 844-365-2202
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Fax | 844-558-1878
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Provider Business Mailing Address
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Address Line | 291 CARTER DR STE B
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City | MIDDLETOWN
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State | DE
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Zip | 19709-5845
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Country | US
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Telephone | 844-365-2202
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Fax | 844-558-1878
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | KELSEY ROPER
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Credential |
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Telephone | 844-365-2202
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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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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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