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NPI Code Detail

MEDICARE: ANBAP WELLNESS LLC

MEDICARE: ANBAP 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
1364SF0001XFamily Health Clinical Nurse Specialist758246TX

General Provider Information

NPI Number : 1073913588
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANBAP WELLNESS LLC
Provider Business Mailing Address
First Line : 560 LARRY WARD
Second Line :
City : BRIDGE CITY
State : TX
Zip : 77611-2432
Country : US
Telephone Number : 409-221-8294
Fax Number :
Provider Business Practice Location Address
First Line : 1001 NEDERLAND AVE
Second Line :
City : NEDERLAND
State : TX
Zip : 77627-2832
Country : US
Telephone Number : 409-221-8294
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. KEVIN G MORGAN
Credential : FNP-BC
Telephone Number : 409-221-8294
Provider Enumeration Date : 09/03/2014
Last Update Date : 09/08/2014

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Directions to “ANBAP WELLNESS LLC ” Practice Location

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