National Provider Identifier Database

FORT MILL SENIOR WELLNESS LLC
Nurse Practitioner

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.


Contact Information

FORT MILL SENIOR WELLNESS LLC
331 E MAIN ST STE 200
ROCK HILL, SC29730-5384
Phone: 704-438-0687
Fax: 844-591-0104
Website:
Specialty Taxonomy Code
* Nurse Practitioner 363L00000X
Geriatric Medicine 207RG0300X
Geriatric Psychiatry 2084P0805X
Psychiatric/Mental Health 363LP0808X

* Indicates primary specialty

NPI Profile & details for FORT MILL SENIOR WELLNESS LLC

NPI Number 1336992601
Legal business name
LBN
FORT MILL SENIOR WELLNESS LLC
Authorized official KELLI GAGNE - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 04/08/2024
Last updated 04/08/2024 - About 2 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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