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NPI Code Detail

MEDICARE: FORBES WELLNESS LLC

MEDICARE: FORBES WELLNESS LLC
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
1363LA2200XAdult Health Nurse Practitioner

General Provider Information

NPI Number : 1568020691
Entity Type Code : Organization
Provider Name (Legal Business Name) : FORBES WELLNESS LLC
Provider Business Mailing Address
First Line : PO BOX 828
Second Line :
City : OCCOQUAN
State : VA
Zip : 22125-0828
Country : US
Telephone Number : 703-690-8482
Fax Number :
Provider Business Practice Location Address
First Line : 9107 OAK CHASE CT
Second Line :
City : FAIRFAX STATION
State : VA
Zip : 22039-3333
Country : US
Telephone Number : 703-690-8482
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JILL E FORBES
Credential : NP
Telephone Number : 703-690-8482
Provider Enumeration Date : 06/04/2019
Last Update Date : 06/04/2019

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Directions to “FORBES WELLNESS LLC ” Practice Location

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