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General NPI Number Information
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NPI Number | 1821771395
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Entity Type | Organization
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Legal Business Name | HEALTHY MINDZ
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 14201 W SUNRISE BLVD STE 208
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City | SUNRISE
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State | FL
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Zip | 33323-3207
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Country | US
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Telephone | 954-816-0273
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Fax | 866-900-1122
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Provider Business Mailing Address
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Address Line | 11301 NW 31ST ST
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City | SUNRISE
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State | FL
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Zip | 33323-1401
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Country | US
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Telephone | 954-816-0273
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Fax | 866-900-1122
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Authorized Official
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Title or Position | NURSE PRACTIONER
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Name | TAMMY EWING
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Credential | ARNP
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Telephone | 954-816-0273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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