Provider Demographics
NPI:1366041733
Name:NP HEALTH & WELLNESS CENTER A PROFESSIONAL NURSING CORPORATION
Entity Type:Organization
Organization Name:NP HEALTH & WELLNESS CENTER A PROFESSIONAL NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CE0 / EMPLOYEE OF CORPORATION
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:COATES-LEISEN
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:805-719-1700
Mailing Address - Street 1:1429 E THOUSAND OAKS BLVD
Mailing Address - Street 2:#108
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-2801
Mailing Address - Country:US
Mailing Address - Phone:805-719-1700
Mailing Address - Fax:805-719-1711
Practice Address - Street 1:1429 E THOUSAND OAKS BLVD
Practice Address - Street 2:#108
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362
Practice Address - Country:US
Practice Address - Phone:805-719-1700
Practice Address - Fax:805-719-1711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-18
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1134523558OtherINDIVIDUAL NPI