Organization
BE WELL ADULT, NP, PLLC
Active
Parent organization
BE WELL ADULT, NP, PLLC
Other names
Envision Intergrative Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
BE WELL ADULT, NP, PLLC
Authorized official
NICOLE FLEMMING CPC,CRC,CPC,CBCS,CMA (BILLING AND CREDENTIALING MANAGER)
(843) 640-9342
Entity
Organization
Contact information
Practice address
1461 LAKELAND AVE UNIT 9, BOHEMIA, NY 11716-2174
(631) 467-8224
(631) 585-7575
Mailing address
1461 LAKELAND AVE UNIT 9, BOHEMIA, NY 11716-2174
(631) 467-8224
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/28/2024
Last updated
06/06/2024
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