Provider Demographics
NPI:1881424547
Name:WOUND HEALING ADVANTAGE
Entity type:Organization
Organization Name:WOUND HEALING ADVANTAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:NATACHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCHET
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:561-306-0451
Mailing Address - Street 1:12172 89TH PL N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412-2379
Mailing Address - Country:US
Mailing Address - Phone:561-306-0451
Mailing Address - Fax:
Practice Address - Street 1:12172 89TH PL N
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33412-2379
Practice Address - Country:US
Practice Address - Phone:561-306-0451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty