Provider Demographics
NPI:1255106100
Name:NURTURED PELVIC HEALTH & WELLNESS
Entity type:Organization
Organization Name:NURTURED PELVIC HEALTH & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:201-213-5202
Mailing Address - Street 1:44 PAWNEE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE HIAWATHA
Mailing Address - State:NJ
Mailing Address - Zip Code:07034-3010
Mailing Address - Country:US
Mailing Address - Phone:201-213-5202
Mailing Address - Fax:
Practice Address - Street 1:44 PAWNEE AVE
Practice Address - Street 2:
Practice Address - City:LAKE HIAWATHA
Practice Address - State:NJ
Practice Address - Zip Code:07034-3010
Practice Address - Country:US
Practice Address - Phone:201-213-5202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service