Provider Demographics
NPI:1639774722
Name:AJ'S HEALTH & WELLNESS ENTERPRISES PLLC
Entity Type:Organization
Organization Name:AJ'S HEALTH & WELLNESS ENTERPRISES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN
Authorized Official - Phone:870-413-9968
Mailing Address - Street 1:1400 W 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-7010
Mailing Address - Country:US
Mailing Address - Phone:870-413-9968
Mailing Address - Fax:870-535-0594
Practice Address - Street 1:1400 W 43RD AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7010
Practice Address - Country:US
Practice Address - Phone:870-413-9968
Practice Address - Fax:870-535-0594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute CareGroup - Multi-Specialty
No364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARA003764OtherARKANSAS STATE BOARD OF NURSING
ARC6070OtherARKANSAS STATE MEDICAL BOARD