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General NPI Number Information
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NPI Number | 1851180046
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Entity Type | Organization
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Legal Business Name | A1 INTEGRATED WELLNESS, LLC
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 526 S CONKLING ST
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City | BALTIMORE
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State | MD
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Zip | 21224-4201
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Country | US
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Telephone | 240-433-3557
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Fax |
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Provider Business Mailing Address
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Address Line | 526 S CONKLING ST
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City | BALTIMORE
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State | MD
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Zip | 21224-4201
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Country | US
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Telephone | 240-433-3557
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Fax | 463-362-2504
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Authorized Official
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Title or Position | CEO
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Name | MS. JYLLA DEANE ARTIS
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Credential | CRNP
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Telephone | 443-226-0748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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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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Taxonomy #3
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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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