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General NPI Number Information
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NPI Number | 1851607329
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Entity Type | Organization
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Legal Business Name | NEW LIFE HEALTH AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 08/23/2010
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 12 PROSPECT ST
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-3211
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Country | US
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Telephone | 973-429-4850
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Fax | 973-429-4811
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Provider Business Mailing Address
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Address Line | 12 PROSPECT ST
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-3211
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Country | US
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Telephone | 973-429-4850
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Fax | 973-429-4811
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Authorized Official
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Title or Position | ADVANCE PRACTICE NURSE
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Name | MS. JOANNE WEBB-WILLIAMS
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Credential | APN-C
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Telephone | 973-429-4850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 26NN06957700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NN05973400
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License Number State | NJ
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