MEDICARE: MAYA SIMAND FNLP, HANP, NBHWC

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	171400000X	Health & Wellness Coach

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000	OTHER		365 HEALTH INSIDE AND OUT

General Provider Information

NPI Number	:	1083344436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYA SIMAND FNLP, HANP, NBHWC

Provider Business Mailing Address
First Line	:	12800 TURTLE ROCK RD APT 5108
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78729-4826
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12800 TURTLE ROCK RD APT 5108
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78729-4826
Country	:	US
Telephone Number	:	847-894-5829
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2022
Last Update Date	:	06/16/2022

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