| NPI | 1245901495 |
|---|---|
| Doing Business As | HEALTH AND WELLNESS BOUTIQUE |
| Entity Type | Organization |
| Authorized Contact | JANEL JENE WILLINGHAM CEO/ Nurse Pracititoner 502-802-0692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2021-09-27 |