Provider Demographics
NPI:1942834908
Name:UNITED HEALTH AND WELLNESS SERVICES, LLC
Entity Type:Organization
Organization Name:UNITED HEALTH AND WELLNESS SERVICES, LLC
Other - Org Name:UNITED HEALTH AND WELLNESS SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ABIODUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEBISI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:912-320-7573
Mailing Address - Street 1:501 STARLING VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-7935
Mailing Address - Country:US
Mailing Address - Phone:912-320-7573
Mailing Address - Fax:
Practice Address - Street 1:501 STARLING VIEW CIR
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:GA
Practice Address - Zip Code:30017-7935
Practice Address - Country:US
Practice Address - Phone:912-320-7573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-28
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty