Provider Demographics
NPI:1659017010
Name:PASSION HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:PASSION HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANDI
Authorized Official - Middle Name:A
Authorized Official - Last Name:NEHRING
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:941-809-8475
Mailing Address - Street 1:6916 44TH TER E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-4243
Mailing Address - Country:US
Mailing Address - Phone:941-809-8475
Mailing Address - Fax:
Practice Address - Street 1:6916 44TH TER E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-4243
Practice Address - Country:US
Practice Address - Phone:941-809-8475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty