NPI | 1811774243 |
---|---|
Former Legal Business Name | THE REMEDY HYDRATION & WELLNESS, PLLC |
Entity Type | Organization |
Authorized Contact | TAMIQUA JACKSON LUCKEY Owner 919-410-7445 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2023-09-11 |
Last Update Date | 2023-12-02 |