Provider Demographics
NPI:1336870484
Name:WOMEN'S HEALTH 360, LLC
Entity Type:Organization
Organization Name:WOMEN'S HEALTH 360, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLIE
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:407-986-3553
Mailing Address - Street 1:7975 NEMOURS PKWY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7687
Mailing Address - Country:US
Mailing Address - Phone:407-271-2796
Mailing Address - Fax:
Practice Address - Street 1:6009 S ORANGE AVE UNIT 6017
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4237
Practice Address - Country:US
Practice Address - Phone:407-986-3553
Practice Address - Fax:407-809-1473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Single Specialty