Provider Demographics
NPI:1073181855
Name:TRUEBIO INNOVATIVE HEALTH & WELLNESS
Entity Type:Organization
Organization Name:TRUEBIO INNOVATIVE HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCNEIL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:336-999-9311
Mailing Address - Street 1:150 CHARLOIS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1549
Mailing Address - Country:US
Mailing Address - Phone:336-999-9311
Mailing Address - Fax:
Practice Address - Street 1:150 CHARLOIS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1549
Practice Address - Country:US
Practice Address - Phone:336-999-9311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-16
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty