Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Social Worker |
104100000X |
| NPI # | 1588325310 |
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| LBN Legal business name | FAMILY CARE WELLNESS LLC | ||||||||||||
| Authorized official | WHITNEY BLANKENSHIP - (APN/OWNER) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 01/04/2022 | ||||||||||||
| Last updated | 02/13/2024 - About 2 years ago | ||||||||||||
| Identifiers |
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