Provider Demographics
NPI:1467995779
Name:MT. JULIET HEALTH AND WELLNESS, LLC
Entity Type:Organization
Organization Name:MT. JULIET HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WEDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:615-553-5002
Mailing Address - Street 1:1097 WESTON DR STE B
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3493
Mailing Address - Country:US
Mailing Address - Phone:615-553-5002
Mailing Address - Fax:615-535-5941
Practice Address - Street 1:1097 WESTON DR
Practice Address - Street 2:SUITE B
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-3493
Practice Address - Country:US
Practice Address - Phone:615-553-5002
Practice Address - Fax:615-535-5941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty