Provider Demographics
NPI:1821552647
Name:SUCCESSFUL CONNECTIONS, LLC
Entity Type:Organization
Organization Name:SUCCESSFUL CONNECTIONS, LLC
Other - Org Name:SUCCESSFUL CONNECTIONS HEALTH AND WELLNESS INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:PANDORA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:612-272-8009
Mailing Address - Street 1:4201 3RD ST NE APT 6
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-2742
Mailing Address - Country:US
Mailing Address - Phone:612-730-3945
Mailing Address - Fax:
Practice Address - Street 1:4201 3RD ST NE APT 6
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-2742
Practice Address - Country:US
Practice Address - Phone:612-730-3945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH EMPOWERMENT INSTITUTE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-25
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty