Provider Demographics
NPI:1841901634
Name:WELLNESSMANER HEALTHCARE SERVICES
Entity type:Organization
Organization Name:WELLNESSMANER HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CECILE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-750-0441
Mailing Address - Street 1:1791 COLONIAL SOUTH DR SW
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-4229
Mailing Address - Country:US
Mailing Address - Phone:404-279-2254
Mailing Address - Fax:
Practice Address - Street 1:1791 COLONIAL SOUTH DR SW
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-4229
Practice Address - Country:US
Practice Address - Phone:404-279-2254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care