Provider Demographics
NPI:1508200791
Name:WELLNESS INNOVATIONS & NURSING SERVICES, LLC
Entity Type:Organization
Organization Name:WELLNESS INNOVATIONS & NURSING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF WELLNESS SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:PELLATT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:715-832-9467
Mailing Address - Street 1:14425 COLLEGE BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2317
Mailing Address - Country:US
Mailing Address - Phone:913-948-5200
Mailing Address - Fax:913-948-5392
Practice Address - Street 1:14425 COLLEGE BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-2317
Practice Address - Country:US
Practice Address - Phone:913-948-5200
Practice Address - Fax:913-948-5392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care