Balanced Wellness Primary Care, LLC
Nurse Practitioner, Family in Uncasville, Connecticut
1780926774- Practice location
- 620 Norwich New London Tpke, Uncasville, CT 06382
- Phone
- 860-892-8012
- Fax
- 860-892-8027
- Last updated
- June 17, 2022
Balanced Wellness Primary Care, LLC is a healthcare organization based in Uncasville, CT. Balanced Wellness Primary Care, LLC practices in Uncasville, CT. The NPI Number for Balanced Wellness Primary Care, LLC is 1780926774 and holds a License No. 004797 (CT). The current practice location address for Balanced Wellness Primary Care, LLC is 620 Norwich New London Tpke, Uncasville, CT 06382 and can be reached out via phone at 860-892-8012 and via fax at 860-892-8027.
Provider Profile Details
- NPI Number
- 1780926774
- Provider Name
- Balanced Wellness Primary Care, LLC
- Provider Entity Type
- Organization
- Address
- 620 Norwich New London Tpke, Uncasville, CT 06382
- Phone Number
- 860-892-8012
- Fax Number
- 860-892-8027
- Primary Taxonomy
- Nurse Practitioner, Family · 363LF0000X
- Organization Subpart
- No
- Authorized Official
- Kristin Marie Mahan · Owner · 860-892-8012
- Provider Enumeration Date
- March 18, 2013
- Last Update Date
- June 17, 2022
- Certification Date
- June 16, 2022
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 620 Norwich New London Tpke
Uncasville, CT 06382 - City
- Uncasville
- State
- Connecticut
- Zip
- 06382
- Phone Number
- 860-892-8012
- Fax Number
- 860-892-8027
Provider Business Mailing Address Details
- Address
- 620 Norwich New London Tpke
Uncasville, CT 06382 - City
- Uncasville
- State
- CT
- Zip
- 06382
- Phone Number
- 860-892-8012
- Fax Number
- 860-892-8027
License Information
- License Number
- 004797
- License State
- CT
- Taxonomy
- Nurse Practitioner, Family · 363LF0000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Balanced Wellness Primary Care, LLC?
The NPI number of Balanced Wellness Primary Care, LLC is 1780926774. It was assigned on March 18, 2013 and is currently active in the NPPES registry.
What is the specialty of Balanced Wellness Primary Care, LLC?
Balanced Wellness Primary Care, LLC is registered under the primary taxonomy Nurse Practitioner, Family (code 363LF0000X), licensed in CT under license number 004797.
Where does Balanced Wellness Primary Care, LLC practice?
The practice location is 620 Norwich New London Tpke, Uncasville, CT 06382. The office can be reached at 860-892-8012 (phone) or 860-892-8027 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1780926774 directly on the NPPES registry website.