Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI # | 1114681350 |
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| LBN Legal business name | CYPRESS HEALTH AND WELLNESS LLC | ||||||||
| Authorized official | JAIMIE MELANCON - (MANAGER) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 10/25/2021 | ||||||||
| Last updated | 10/25/2021 - About 5 years ago | ||||||||
| Identifiers |
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