Provider Demographics
NPI:1982242418
Name:JUST ENJOY LIFE ACUPUNCTURIST AND NURSE PRACTITIONER IN ADULT HEALTH
Entity Type:Organization
Organization Name:JUST ENJOY LIFE ACUPUNCTURIST AND NURSE PRACTITIONER IN ADULT HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ NP/ ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MUILENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:ANP, LAC
Authorized Official - Phone:631-675-1895
Mailing Address - Street 1:2500 ROUTE 347 BLDG 6D
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2552
Mailing Address - Country:US
Mailing Address - Phone:631-675-1895
Mailing Address - Fax:631-675-1896
Practice Address - Street 1:2500 ROUTE 347 BLDG 6D
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2552
Practice Address - Country:US
Practice Address - Phone:631-675-1895
Practice Address - Fax:631-675-1896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty