Provider Demographics
NPI:1942908181
Name:NURTURE WELLNESS, PLLC
Entity Type:Organization
Organization Name:NURTURE WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:ALAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-622-6897
Mailing Address - Street 1:2512 INDEPENDENCE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-0019
Mailing Address - Country:US
Mailing Address - Phone:602-390-0628
Mailing Address - Fax:
Practice Address - Street 1:2512 INDEPENDENCE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-0019
Practice Address - Country:US
Practice Address - Phone:602-390-0628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1780231431OtherNPI