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General NPI Number Information
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NPI Number | 1689560500
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Entity Type | Organization
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Legal Business Name | MINDFUL SHINE, LLC
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 4049 PENNSYLVANIA AVE STE 203
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City | KANSAS CITY
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State | MO
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Zip | 64111-3022
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Country | US
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Telephone | 913-313-9406
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Fax |
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Provider Business Mailing Address
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Address Line | 4540 LINDELL BLVD APT 106
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2040
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Country | US
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Telephone | 913-313-9406
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | BRITTANY NICOLE JONES-WELDON
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Credential |
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Telephone | 913-313-9406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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