Provider Demographics
NPI:1356098289
Name:DIRECT CARE AND WELLNESS, INC
Entity type:Organization
Organization Name:DIRECT CARE AND WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:APRYL
Authorized Official - Middle Name:H
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, FNP-C
Authorized Official - Phone:813-997-6265
Mailing Address - Street 1:24502 MALVERN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-4928
Mailing Address - Country:US
Mailing Address - Phone:813-997-6265
Mailing Address - Fax:949-222-2843
Practice Address - Street 1:24502 MALVERN ST
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-4928
Practice Address - Country:US
Practice Address - Phone:813-997-6265
Practice Address - Fax:949-222-2843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center