Provider Demographics
NPI:1497524524
Name:INFINITY AND WELLNESS FAMILY PRACTICE, PLLC
Entity type:Organization
Organization Name:INFINITY AND WELLNESS FAMILY PRACTICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:HUNT
Authorized Official - Last Name:LOCKLEAR
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:910-887-2041
Mailing Address - Street 1:1007 WOODRIDGE DR STE A
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-3328
Mailing Address - Country:US
Mailing Address - Phone:910-887-2041
Mailing Address - Fax:910-887-2048
Practice Address - Street 1:1007 WOODRIDGE DR STE A
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3328
Practice Address - Country:US
Practice Address - Phone:910-887-2041
Practice Address - Fax:910-887-2048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-29
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1326509472OtherNPI
NC1033752415OtherNPI