# BLUE MOUNTAIN WELLNESS, PLLC

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

## Provider details

- **NPI number:** 1477113637
- **Authorized official:** MS. LUCILLE CONSTANTINE CRNP (OWNER)
- **Authorized official phone:** (215) 647-2175

## Contact information

- **Practice address:** 517 N BROAD ST, LANSDALE, PA 19446-2415
- **Practice address phone:** (215) 647-2175
- **Mailing address:** 517 N BROAD ST, LANSDALE, PA 19446-2415
- **Mailing address phone:** (215) 647-2175

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/19/2019
- **Last updated:** 01/11/2023