Provider Demographics
NPI:1134799018
Name:WORT WELLBEING WOMEN'S CLINIC, PLLC
Entity type:Organization
Organization Name:WORT WELLBEING WOMEN'S CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADVANCED PRACTICE REGISTERED NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:WHNP-BC
Authorized Official - Phone:254-640-9118
Mailing Address - Street 1:520 E VINE ST UNIT 2443
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76244-3902
Mailing Address - Country:US
Mailing Address - Phone:254-640-9118
Mailing Address - Fax:
Practice Address - Street 1:520 E VINE ST UNIT 2443
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76244-3902
Practice Address - Country:US
Practice Address - Phone:254-640-9118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty