MEDICARE: FUSION HEALTH AND WELLNESS

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	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1104774884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FUSION HEALTH AND WELLNESS

Provider Business Mailing Address
First Line	:	1070 EAGLES LANDING PKWY
Second Line	:
City	:	STOCKBRIDGE
State	:	GA
Zip	:	30281-5012
Country	:	US
Telephone Number	:	678-458-4299
Fax Number	:	470-878-1259

Provider Business Practice Location Address
First Line	:	1070 EAGLES LANDING PKWY
Second Line	:
City	:	STOCKBRIDGE
State	:	GA
Zip	:	30281-5012
Country	:	US
Telephone Number	:	678-458-4299
Fax Number	:	470-878-1259

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. YUDELKY TEREZA BENTLEY
Credential	:	NP-C
Telephone Number	:	678-458-4299

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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Directions to “FUSION HEALTH AND WELLNESS ” Practice Location

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