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NPI Code Detail

MEDICARE: HINES HEALTH AND WELLNESS PLLC

MEDICARE: HINES HEALTH AND WELLNESS PLLC
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
1363L00000XNurse Practitioner

General Provider Information

NPI Number : 1265103956
Entity Type Code : Organization
Provider Name (Legal Business Name) : HINES HEALTH AND WELLNESS PLLC
Provider Business Mailing Address
First Line : 3980 PREMIER DR STE 110
Second Line :
City : HIGH POINT
State : NC
Zip : 27265-8409
Country : US
Telephone Number : 336-252-4524
Fax Number :
Provider Business Practice Location Address
First Line : 3980 PREMIER DR STE 110
Second Line :
City : HIGH POINT
State : NC
Zip : 27265-8409
Country : US
Telephone Number : 336-252-4524
Fax Number :
Authorized Official
Title or Position : CREDENTIALING SPECIALIST
Name : URSULA LEWIS
Credential :
Telephone Number : 910-231-5655
Provider Enumeration Date : 09/23/2021
Last Update Date : 09/27/2021

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Directions to “HINES HEALTH AND WELLNESS PLLC ” Practice Location

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