EVIBRANT MENTAL WELLNESS NPI 1093598302

NPI Information

NPI: 1093598302
Provider Name: EVIBRANT MENTAL WELLNESS
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
3122 NEALY WAY STE 201
LONGVIEW, TX
ZIP 75605
Phone: (903) 833-9875
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EVIBRANT MENTAL WELLNESS is a psychiatric/mental health nurse practitioner in Longview, TX. EVIBRANT MENTAL WELLNESS NPI is 1093598302. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3122 NEALY WAY STE 201
LONGVIEW, TX
ZIP 75605-092
Phone: (903) 833-9875

The provider's authorized official is Keisha Marsolan .
The authorized official title is Owner/ceo and has the following contact phone number (903) 452-0680.

The enumeration date for this NPI number is 8/18/2023 and was last updated on 8/18/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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