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NPI Code Detail

MEDICARE: THE NOURISH FOUNDATION

MEDICARE: THE NOURISH FOUNDATION
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
1208000000XPediatrics Physician

General Provider Information

NPI Number : 1467197335
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE NOURISH FOUNDATION
Provider Business Mailing Address
First Line : 1323 AUBURN ST
Second Line :
City : OPELIKA
State : AL
Zip : 36801-7801
Country : US
Telephone Number : 334-610-1576
Fax Number :
Provider Business Practice Location Address
First Line : 1323 AUBURN ST
Second Line :
City : OPELIKA
State : AL
Zip : 36801-7801
Country : US
Telephone Number : 334-610-1576
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. KATIE A WOLTER
Credential : MD
Telephone Number : 334-610-1576
Provider Enumeration Date : 05/04/2022
Last Update Date : 05/04/2022

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Directions to “THE NOURISH FOUNDATION ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.