Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner | |
Case Manager/Care Coordinator |
171M00000X | |||
Nurse Practitioner |
363L00000X | 50 | Nurse Practitioner |
| NPI # | 1790433456 |
| LBN Legal business name | BALANCED WELLNESS LLC |
| Authorized official | JESSICA BREWER - (AUTHORIZED OFFICIAL) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 03/11/2022 |
| Last updated | 07/13/2025 - About 11 months ago |
| Identifiers | n/a |
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BALANCED WELLNESS LLC
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