Provider Demographics
NPI:1629548359
Name:ABUNDANT WELLNESS
Entity Type:Organization
Organization Name:ABUNDANT WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GERMANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-527-4659
Mailing Address - Street 1:101 W WASHINGTON ST STE C1
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-2434
Mailing Address - Country:US
Mailing Address - Phone:601-856-2383
Mailing Address - Fax:
Practice Address - Street 1:101 W WASHINGTON ST STE C1
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-2434
Practice Address - Country:US
Practice Address - Phone:601-856-2383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty