Organization
CREATE U MEDICAL WEIGHT LOSS, PLLC
Active
Other names
CU Infusion, Create U Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY JACKSON (CEO)
(704) 781-8170
Entity
Organization
Contact information
Practice address
10210 HICKORYWOOD HILL AVE STE 200, HUNTERSVILLE, NC 28078-3417
(704) 781-8170
Mailing address
400 GILEAD RD STE 651, HUNTERSVILLE, NC 28078-6899
(704) 781-8170
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
163WG0000X
General Practice Registered Nurse
—
—
163WI0500X
Infusion Therapy Registered Nurse
—
—
163WP2201X
Ambulatory Care Registered Nurse
—
—
163WW0000X
Wound Care Registered Nurse
—
—
164W00000X
Licensed Practical Nurse
—
—
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225700000X
Massage Therapist
—
—
251F00000X
Home Infusion Agency
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053556399
NPI
—
01
—
1487948154
NPI
—
Enumeration date
12/09/2021
Last updated
07/13/2022
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