Organization
AWAKEN WELLNESS NC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANYA GIBBS FNP (OWNER/PRESIDENT)
(910) 644-0588
Entity
Organization
Contact information
Practice address
2529 RAEFORD RD, FAYETTEVILLE, NC 28305-5098
(910) 644-0588
(725) 209-1671
Mailing address
5964 DALTON RD, FAYETTEVILLE, NC 28314-1022
(910) 973-2689
(725) 209-1671
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/27/2021
Last updated
08/06/2021
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