MEDICARE: PRESERVATION WELLNESS CO.

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	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1669252854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESERVATION WELLNESS CO.

Provider Business Mailing Address
First Line	:	1302 WATSON BLVD STE 1090
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-3436
Country	:	US
Telephone Number	:	404-683-9844
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 CONSTITUTION DR STE 500
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-8047
Country	:	US
Telephone Number	:	404-683-9844
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MISTY LANDOR
Credential	:	NP
Telephone Number	:	404-683-9844

Provider Enumeration Date	:	10/04/2023
Last Update Date	:	03/11/2026

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Directions to “PRESERVATION WELLNESS CO. ” Practice Location

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