Provider Demographics
NPI:1376823310
Name:CONSULTS IN WELLNESS, PLLC
Entity Type:Organization
Organization Name:CONSULTS IN WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:W
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:910-208-0258
Mailing Address - Street 1:PO BOX 1654
Mailing Address - Street 2:
Mailing Address - City:WRIGHTSVILLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28480-9654
Mailing Address - Country:US
Mailing Address - Phone:910-208-0258
Mailing Address - Fax:910-772-4183
Practice Address - Street 1:6317 OLEANDER DR
Practice Address - Street 2:SUITE A
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-3568
Practice Address - Country:US
Practice Address - Phone:910-208-0258
Practice Address - Fax:910-772-4183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201012363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2592328AMedicare UPIN