Provider Demographics
NPI:1225802192
Name:WELL WOMAN LLC
Entity Type:Organization
Organization Name:WELL WOMAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/WHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN
Authorized Official - Phone:404-510-3476
Mailing Address - Street 1:2118 STAFF DR
Mailing Address - Street 2:
Mailing Address - City:CANTONMENT
Mailing Address - State:FL
Mailing Address - Zip Code:32533-7742
Mailing Address - Country:US
Mailing Address - Phone:404-510-3476
Mailing Address - Fax:
Practice Address - Street 1:24 N TARRAGONA ST STE 5
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-6063
Practice Address - Country:US
Practice Address - Phone:404-510-3476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty