Provider Demographics
NPI:1831361393
Name:PWK, INC.
Entity type:Organization
Organization Name:PWK, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:561-719-2385
Mailing Address - Street 1:1897 PALM BEACH LAKES BLVD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3507
Mailing Address - Country:US
Mailing Address - Phone:561-719-2385
Mailing Address - Fax:561-659-2825
Practice Address - Street 1:1897 PALM BEACH LAKES BLVD
Practice Address - Street 2:SUITE 222
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3507
Practice Address - Country:US
Practice Address - Phone:561-719-2385
Practice Address - Fax:561-659-2825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2594912363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty