Provider Demographics
NPI:1225666563
Name:CENTRAL PENNSYLVANIA HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:CENTRAL PENNSYLVANIA HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/CO OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:MCCORD
Authorized Official - Suffix:
Authorized Official - Credentials:FNP, CRNP
Authorized Official - Phone:814-577-7856
Mailing Address - Street 1:1114 WALTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-2748
Mailing Address - Country:US
Mailing Address - Phone:814-577-7856
Mailing Address - Fax:814-342-5815
Practice Address - Street 1:1114 WALTON ST STE A
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-2748
Practice Address - Country:US
Practice Address - Phone:814-577-7856
Practice Address - Fax:814-342-5815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-31
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty