MEDICARE: WELLNESS NURSE PRACTITIONER IN PSYCHIATRY AND FAMILY HEALTH, 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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1457291692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLNESS NURSE PRACTITIONER IN PSYCHIATRY AND FAMILY HEALTH, PLLC

Provider Business Mailing Address
First Line	:	713 EVELYN AVE
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-1307
Country	:	US
Telephone Number	:	917-691-5853
Fax Number	:	516-968-2054

Provider Business Practice Location Address
First Line	:	713 EVELYN AVE
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-1307
Country	:	US
Telephone Number	:	917-691-5853
Fax Number	:	516-968-2054

Authorized Official
Title or Position	:	CEO
Name	:	MRS. TAMARA SONETTA MULLER
Credential	:	NP
Telephone Number	:	917-691-5853

Provider Enumeration Date	:	03/30/2026
Last Update Date	:	06/03/2026

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