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General NPI Number Information
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NPI Number | 1821914730
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Entity Type | Organization
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Legal Business Name | BJC TOTAL WELLNESS LLC
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Dates
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Enumeration Date | 06/25/2026
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Last Update Date | 06/25/2026
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Provider Practice Location Address
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Address Line | 285 S CHURCH ST STE 1
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City | MOORESTOWN
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State | NJ
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Zip | 08057-2773
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Country | US
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Telephone | 856-652-0222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8755
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City | BLACKWOOD
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State | NJ
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Zip | 08012-8755
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Country | US
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Telephone | 732-948-6718
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | BRYANA CARREA
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Credential | APN
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Telephone | 732-948-6718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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