Provider Demographics
NPI:1649064643
Name:BLOOMING MINDS WELLNESS NOOK
Entity type:Organization
Organization Name:BLOOMING MINDS WELLNESS NOOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SPAULDING
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC
Authorized Official - Phone:808-562-8000
Mailing Address - Street 1:1050 QUEEN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4130
Mailing Address - Country:US
Mailing Address - Phone:808-562-8000
Mailing Address - Fax:
Practice Address - Street 1:1050 QUEEN ST STE 100
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4130
Practice Address - Country:US
Practice Address - Phone:808-562-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty