Provider Demographics
NPI:1821777335
Name:INTEGRATIVE HEALTH & WELLNESS PLLC
Entity Type:Organization
Organization Name:INTEGRATIVE HEALTH & WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:717-844-0046
Mailing Address - Street 1:1656 W MAIN STREET
Mailing Address - Street 2:SUITE 3
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-1103
Mailing Address - Country:US
Mailing Address - Phone:717-863-5387
Mailing Address - Fax:717-863-5371
Practice Address - Street 1:1656 W MAIN STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522
Practice Address - Country:US
Practice Address - Phone:717-863-5387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty