Provider Demographics
NPI:1477207314
Name:NORTHEND HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:NORTHEND HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TSITSI
Authorized Official - Middle Name:
Authorized Official - Last Name:MUHOMA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:502-240-9037
Mailing Address - Street 1:3344 COBB PKWY NW STE 2001015
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-8344
Mailing Address - Country:US
Mailing Address - Phone:502-240-9037
Mailing Address - Fax:
Practice Address - Street 1:609 CEREMONY WAY
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-3730
Practice Address - Country:US
Practice Address - Phone:502-240-9037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty