Provider Demographics
NPI:1013598358
Name:365 WELLNESS
Entity Type:Organization
Organization Name:365 WELLNESS
Other - Org Name:365 WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ROSHINI
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:954-439-0633
Mailing Address - Street 1:7611 SANTEE TER
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7866
Mailing Address - Country:US
Mailing Address - Phone:195-443-9063
Mailing Address - Fax:
Practice Address - Street 1:7611 SANTEE TER
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-7866
Practice Address - Country:US
Practice Address - Phone:561-770-8072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-19
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty