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General NPI Number Information
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NPI Number | 1881413771
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Entity Type | Organization
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Legal Business Name | FAMALAOAN WELLNESS CENTER
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 744 N MARINE CORPS DR STE 121
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City | TAMUNING
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State | GU
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Zip | 96913-4426
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Country | US
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Telephone | 671-487-5291
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Fax |
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Provider Business Mailing Address
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Address Line | 744 N MARINE CORPS DR STE 121
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City | TAMUNING
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State | GU
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Zip | 96913-4426
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Country | US
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Telephone | 671-588-2394
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | KELLI JARRETT
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Credential | MD
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Telephone | 671-588-2394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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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 | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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