Provider Demographics
NPI:1609358076
Name:AWW HEALTH CONNECTION LLC
Entity Type:Organization
Organization Name:AWW HEALTH CONNECTION LLC
Other - Org Name:AWW HEALTH CONNECTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ARNP/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARNESSA
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:WESTON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:229-444-2646
Mailing Address - Street 1:1142 ROAN CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-7030
Mailing Address - Country:US
Mailing Address - Phone:229-444-2646
Mailing Address - Fax:
Practice Address - Street 1:1142 ROAN CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-7030
Practice Address - Country:US
Practice Address - Phone:229-444-2646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-03
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9329061363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty