Provider Demographics
NPI:1659199784
Name:ADAPTIVE HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:ADAPTIVE HEALTH AND WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FAAMILY NURSSE PRACTITIONER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:D
Authorized Official - Last Name:DALTON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:435-590-8322
Mailing Address - Street 1:2202 N MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-9772
Mailing Address - Country:US
Mailing Address - Phone:435-865-1500
Mailing Address - Fax:435-383-4495
Practice Address - Street 1:2202 N MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-9772
Practice Address - Country:US
Practice Address - Phone:435-865-1500
Practice Address - Fax:435-383-4495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily HealthGroup - Single Specialty