Provider Demographics
NPI:1154067155
Name:WELLNESS INSTITUTE OF NEPHROLOGY, LLC (WIN)
Entity Type:Organization
Organization Name:WELLNESS INSTITUTE OF NEPHROLOGY, LLC (WIN)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MALIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-939-3640
Mailing Address - Street 1:26 PLATT ST
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-1065
Mailing Address - Country:US
Mailing Address - Phone:504-939-3640
Mailing Address - Fax:504-469-7138
Practice Address - Street 1:200 W ESPLANADE AVE STE 305
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2474
Practice Address - Country:US
Practice Address - Phone:504-464-8712
Practice Address - Fax:504-464-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1577464Medicaid
LA4J284OtherMEDICARE