Organization
RENEW WELLNESS CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE THORNE NP (CEO)
(323) 900-5328
Entity
Organization
Contact information
Practice address
300 E 2ND ST STE 1510, RENO, NV 89501-1591
(323) 900-5328
Mailing address
506 S SPRING ST UNIT 13308, LOS ANGELES, CA 90013-3215
(323) 900-5328
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/11/2022
Last updated
02/13/2023
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