Provider Demographics
NPI:1437840832
Name:HEALING HANDS FAMILY MEDICINE LLC
Entity Type:Organization
Organization Name:HEALING HANDS FAMILY MEDICINE LLC
Other - Org Name:HEALING HANDS FAMILY MED
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:LATEMPEST
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:706-615-1034
Mailing Address - Street 1:117 BLACKBOTTOM RD
Mailing Address - Street 2:
Mailing Address - City:SEALE
Mailing Address - State:AL
Mailing Address - Zip Code:36875-4708
Mailing Address - Country:US
Mailing Address - Phone:706-615-1034
Mailing Address - Fax:
Practice Address - Street 1:1425 WYNNTON RD STE A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31906-5718
Practice Address - Country:US
Practice Address - Phone:706-780-6332
Practice Address - Fax:706-786-6442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty