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General NPI Number Information
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NPI Number | 1871369587
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Entity Type | Organization
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Legal Business Name | MINDFUL CONNECTIONS BEHAVIORAL HEALTH , PLLC
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 1656 ROCK CREEK LN
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-7694
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Country | US
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Telephone | 910-785-3461
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Fax |
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Provider Business Mailing Address
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Address Line | 1656 ROCK CREEK LN
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-7694
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Country | US
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Telephone | 910-785-3461
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. CONNIE BAXTER
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Credential | MSN, PMHNP-BC
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Telephone | 910-785-3461
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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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