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Ivydale Wellness Center
Psychiatric/Mental Health Nurse Practitioner in Winder, Georgia
NPI 1659919066

Ivydale Wellness Center is a Psychiatric/Mental Health Nurse Practitioner based in Lawrenceville, GA and is specialized in Psychiatric/Mental Health. Ivydale Wellness Center practices in Winder, GA. The NPI Number for Ivydale Wellness Center is 1659919066 and holds a License No. (Georgia).

The current practice location address for Ivydale Wellness Center is 361 Resource Pkwy, Winder, GA and can be reached out via phone at 770-291-0419.

Location: 361 Resource Pkwy, Winder, GA, 30045-7818
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1659919066
Provider Name
Ivydale Wellness Center
Credential
Provider Entity Type
Organization
Address
361 Resource Pkwy, Winder, GA, 30045-7818
Phone Number
770-291-0419
Fax Number
Provider Enumeration Date
12/16/2019
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
361 Resource Pkwy
City
Winder
State
Georgia
Zip
30680-8364
Phone Number
770-291-0419
Fax Number
person
Provider Business Mailing Address Details
Address
361 Resource Pkwy
City
Winder
State
Georgia
Zip
30680-8364
Phone Number
770-291-0419
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Multi-Specialty
Taxonomy
261QM1300X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 5
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
()
Definition
Definition to come...
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