Provider Demographics
NPI:1518556968
Name:NEXT LEVEL HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:NEXT LEVEL HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FELECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRESTON-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CFNP
Authorized Official - Phone:662-822-1861
Mailing Address - Street 1:200 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLANDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38748-3412
Mailing Address - Country:US
Mailing Address - Phone:662-822-1861
Mailing Address - Fax:
Practice Address - Street 1:115 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HOLLANDALE
Practice Address - State:MS
Practice Address - Zip Code:38748-3845
Practice Address - Country:US
Practice Address - Phone:662-822-1861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty