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General NPI Number Information
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NPI Number | 1962202283
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Entity Type | Organization
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Legal Business Name | NEXGEN WELLNESS GROUP PLLC
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 703 THIMBLE SHOALS BLVD STE B-5
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4533
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Country | US
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Telephone | 757-749-5004
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Fax |
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Provider Business Mailing Address
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Address Line | 703 THIMBLE SHOALS BLVD STE B-5
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4533
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. JESSICA WILLIS
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Credential | NP
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Telephone | 732-691-7337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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