Provider Demographics
NPI:1982365383
Name:SIMPLICITY HEALTH AND WELLNESS, LLC
Entity Type:Organization
Organization Name:SIMPLICITY HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-314-9582
Mailing Address - Street 1:9323 BERKSHIRE CIR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4446
Mailing Address - Country:US
Mailing Address - Phone:423-314-9582
Mailing Address - Fax:
Practice Address - Street 1:9323 BERKSHIRE CIR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-4446
Practice Address - Country:US
Practice Address - Phone:423-314-9582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-07
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty