Provider Demographics
NPI:1659138733
Name:APOLLO BELLA LLC DBA AURORA BLISS HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:APOLLO BELLA LLC DBA AURORA BLISS HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, APRN
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:DORROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, FNP-C, APRN
Authorized Official - Phone:479-858-1695
Mailing Address - Street 1:3807 MCGINNIS DR
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8816
Mailing Address - Country:US
Mailing Address - Phone:479-858-1695
Mailing Address - Fax:
Practice Address - Street 1:3807 MCGINNIS DR
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-8816
Practice Address - Country:US
Practice Address - Phone:479-858-1695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care