Provider Demographics
NPI:1821643172
Name:LONGLEAF WELLNESS PLLC
Entity Type:Organization
Organization Name:LONGLEAF WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MONROE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:910-875-4545
Mailing Address - Street 1:1090 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-3039
Mailing Address - Country:US
Mailing Address - Phone:910-875-4545
Mailing Address - Fax:910-875-8972
Practice Address - Street 1:1090 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-3039
Practice Address - Country:US
Practice Address - Phone:910-875-4545
Practice Address - Fax:910-875-8972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty