Provider Demographics
NPI:1255008702
Name:OPEN ARMS WELLNESS CENTER, PLLC
Entity type:Organization
Organization Name:OPEN ARMS WELLNESS CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILDER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:207-974-6064
Mailing Address - Street 1:9 CINNAMON RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-1622
Mailing Address - Country:US
Mailing Address - Phone:207-974-6064
Mailing Address - Fax:
Practice Address - Street 1:529 ROUTE 16
Practice Address - Street 2:
Practice Address - City:OSSIPEE
Practice Address - State:NH
Practice Address - Zip Code:03814
Practice Address - Country:US
Practice Address - Phone:207-974-6064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty