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General NPI Number Information
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NPI Number | 1871402941
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Entity Type | Organization
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Legal Business Name | WALKS OF LIFE WELLNESS LLC
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 4300 PACES FERRY RD SE STE 500
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City | ATLANTA
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State | GA
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Zip | 30339-5714
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Country | US
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Telephone | 470-210-4553
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Fax | 470-275-0873
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Provider Business Mailing Address
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Address Line | 830 GLENWOOD AVE SE STE 510-251
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City | ATLANTA
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State | GA
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Zip | 30316-1966
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Country | US
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Telephone | 404-933-2238
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASMINE HENRY
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Credential | FNP
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Telephone | 407-933-2238
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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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