MEDICARE: STAT 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1396464335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAT WELLNESS

Provider Business Mailing Address
First Line	:	1465 HOWELL MILL RD NW STE 300A
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-4246
Country	:	US
Telephone Number	:	404-254-5905
Fax Number	:

Provider Business Practice Location Address
First Line	:	1465 HOWELL MILL RD NW STE 300A
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-4246
Country	:	US
Telephone Number	:	404-254-5905
Fax Number	:

Authorized Official
Title or Position	:	CEO AND NURSE PRACTITIONER
Name	:	KRISTIN OJA
Credential	:
Telephone Number	:	404-254-5905

Provider Enumeration Date	:	08/23/2022
Last Update Date	:	08/23/2022

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Directions to “STAT WELLNESS ” Practice Location

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