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Organization
MIND BODY NOURISH LLC
Active
Organization
MIND BODY NOURISH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANISA ORTIZ CRNP (OWNER)
(305) 930-2967
Entity
Organization
Contact information
Practice address
2625 W GIRARD AVE, PHILADELPHIA, PA 19130-1333
(305) 930-2967
Mailing address
2901 MEREDITH PL, BENSALEM, PA 19020-2258
(267) 455-9230
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/09/2025
Last updated
01/09/2025
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