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General NPI Number Information
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NPI Number | 1740195916
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Entity Type | Organization
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Legal Business Name | BALANCED WEIGHT LOSS AND WELLNESS
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 112 N TRADE ST STE 1
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City | TRYON
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State | NC
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Zip | 28782-3053
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Country | US
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Telephone | 828-374-0904
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Fax | 828-372-4657
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Provider Business Mailing Address
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Address Line | 112 N TRADE ST STE 1
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City | TRYON
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State | NC
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Zip | 28782-3053
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FNP
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Name | KELLY ANNETTE CUDD
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Credential |
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Telephone | 828-374-0904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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