Provider Demographics
NPI:1639886732
Name:INTRINSIC HEALTH, PLLC
Entity type:Organization
Organization Name:INTRINSIC HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GALE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, FNP-BC
Authorized Official - Phone:479-531-9747
Mailing Address - Street 1:33 HARLOW DR
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72715-8928
Mailing Address - Country:US
Mailing Address - Phone:479-531-9747
Mailing Address - Fax:
Practice Address - Street 1:401 S RAINBOW RD STE 2
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1509
Practice Address - Country:US
Practice Address - Phone:479-531-9747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care