Provider Demographics
NPI:1164244935
Name:HERWELLNESSNOOK
Entity type:Organization
Organization Name:HERWELLNESSNOOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:MICHELL
Authorized Official - Last Name:SCIPO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:404-704-4992
Mailing Address - Street 1:309 LAUREN DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-7007
Mailing Address - Country:US
Mailing Address - Phone:404-704-4992
Mailing Address - Fax:404-704-4992
Practice Address - Street 1:309 LAUREN DR
Practice Address - Street 2:
Practice Address - City:FAIRBURN
Practice Address - State:GA
Practice Address - Zip Code:30213-7007
Practice Address - Country:US
Practice Address - Phone:404-704-4992
Practice Address - Fax:404-704-4992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty