# DIVINITY WELLNESS CENTER PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235845082
- **Authorized official:** DEXTERIA REBECCA JENKINS AGNP-C (OWNER)
- **Authorized official phone:** (336) 225-1079

## Contact information

- **Practice address:** 620 N DUNLEITH AVE, WINSTON SALEM, NC 27101-3374
- **Practice address phone:** (336) 221-3454
- **Practice address fax:** (336) 245-4601
- **Mailing address:** PO BOX 286, WALLBURG, NC 27373-0286
- **Mailing address phone:** (336) 221-3454
- **Mailing address fax:** (336) 245-4601

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251J00000X | Nursing Care Agency | — | — | — |
| 261QC1500X | Community Health Clinic/Center | — | — | — |
| 261QF0050X | Non-Surgical Family Planning Clinic/Center | — | — | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/25/2023
- **Last updated:** 06/23/2026