MEDICARE: TRUSTED HEALTH AND 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
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1851048037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRUSTED HEALTH AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	899 MARTIN LUTHER KING JR DR
Second Line	:
City	:	MINERAL SPRINGS
State	:	AR
Zip	:	71851-9044
Country	:	US
Telephone Number	:	870-703-3034
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 S MAIN ST
Second Line	:
City	:	NASHVILLE
State	:	AR
Zip	:	71852-2406
Country	:	US
Telephone Number	:	870-455-0256
Fax Number	:

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	SHARONDA MILLER
Credential	:	NURSE PRACTITIONER
Telephone Number	:	870-703-3034

Provider Enumeration Date	:	03/07/2022
Last Update Date	:	07/19/2023

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