Organization
MIND & BODY WELLNESS, PLLC
Active
Organization
MIND & BODY WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEISTEY ELISE TINDALL (OWNER)
(910) 387-3840
Entity
Organization
Contact information
Practice address
3603 W STAGE COACH TRL, SHELBY, NC 28150-9598
(910) 387-3840
(704) 703-9668
Mailing address
3603 W STAGE COACH TRL, SHELBY, NC 28150-9598
(704) 476-9144
(704) 703-9668
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9032489075
—
NC
Enumeration date
02/22/2021
Last updated
05/29/2026
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