Provider Demographics
NPI:1558876847
Name:PAMPERED PODIATRY NURTURING NAILS & FOOT CARE
Entity Type:Organization
Organization Name:PAMPERED PODIATRY NURTURING NAILS & FOOT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WILNELSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AWONIYI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:256-783-3797
Mailing Address - Street 1:PO BOX 1972
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-5413
Mailing Address - Country:US
Mailing Address - Phone:256-783-3797
Mailing Address - Fax:866-594-7549
Practice Address - Street 1:1219 JORDAN LN NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-3000
Practice Address - Country:US
Practice Address - Phone:256-783-3797
Practice Address - Fax:866-594-7549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL290213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty