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General NPI Number Information
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NPI Number | 1922804590
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Entity Type | Organization
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Legal Business Name | NURTURED HEALTH WELLNESS NP IN FAMILY HEALTH PLLC
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 210 E SUNRISE HWY STE 148
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City | FREEPORT
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State | NY
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Zip | 11520-3943
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Country | US
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Telephone | 917-264-7728
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Fax | 866-507-2531
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Provider Business Mailing Address
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Address Line | 11032 168TH ST
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City | JAMAICA
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State | NY
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Zip | 11433-3420
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Country | US
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Telephone | 917-304-2484
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Fax | 866-507-2531
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MS. ALANA HERARD
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Credential | FNP
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Telephone | 917-304-2484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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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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