Organization
NOURISH ADOLESCENT WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA SCHAEFER CPNP (CO-OWNER)
(919) 367-6639
Entity
Organization
Contact information
Practice address
307 S SALEM ST STE 100, APEX, NC 27502-1845
(919) 627-8771
Mailing address
307 S SALEM ST STE 100, APEX, NC 27502-1845
(919) 673-6639
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033710637
—
NC
Enumeration date
11/02/2020
Last updated
09/20/2022
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