MEDICARE: FIGURE 8 INTEGRATIVE HEALTH & WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician
2	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1063272201
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIGURE 8 INTEGRATIVE HEALTH & WELLNESS LLC

Provider Business Mailing Address
First Line	:	15 PARK PL STE C
Second Line	:
City	:	SWANSEA
State	:	IL
Zip	:	62226-2918
Country	:	US
Telephone Number	:	732-425-4363
Fax Number	:	618-257-0715

Provider Business Practice Location Address
First Line	:	15 PARK PL STE C
Second Line	:
City	:	SWANSEA
State	:	IL
Zip	:	62226-2918
Country	:	US
Telephone Number	:	732-425-4363
Fax Number	:	618-257-0715

Authorized Official
Title or Position	:	CLINICAL PRACTICE MANAGER
Name	:	CHARITY NYUGUTO
Credential	:	FNPC
Telephone Number	:	732-425-4363

Provider Enumeration Date	:	03/21/2024
Last Update Date	:	03/21/2024

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