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NPI Code Detail

MEDICARE: PEAK WELLNESS CLINIC PLLC

MEDICARE: PEAK WELLNESS CLINIC 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
1363LF0000XFamily Nurse Practitioner
2363LP0808XPsychiatric/Mental Health Nurse Practitioner

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942719950
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEAK WELLNESS CLINIC PLLC
Provider Business Mailing Address
First Line : 1 BUFFALO AVE NW STE 201
Second Line :
City : CONCORD
State : NC
Zip : 28025-4004
Country : US
Telephone Number : 980-859-2230
Fax Number : 980-206-4155
Provider Business Practice Location Address
First Line : 1 BUFFALO AVE NW STE 201
Second Line :
City : CONCORD
State : NC
Zip : 28025-4004
Country : US
Telephone Number : 980-859-2230
Fax Number : 980-206-4155
Authorized Official
Title or Position : OWNER/PROVIDER
Name : SABINA BENEL
Credential : DNP,PMHNP-BC,FNP-BC
Telephone Number : 980-859-2230
Provider Enumeration Date : 09/21/2017
Last Update Date : 03/08/2021

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Directions to “PEAK WELLNESS CLINIC PLLC ” Practice Location

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