Organization
NURSE PRACTITIONER WOMEN'S HEALTH, PLLC
Active
Other names
Lifestyle Wellness Enterprise, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOHNETTA MINER NP (CEO/PRESIDENT)
17183791290
Entity
Organization
Contact information
Practice address
140 DARROW PL, SUITE 16B, BRONX, NY 10475-1802
(718) 379-1290
(718) 379-8597
Mailing address
140 DARROW PL, SUITE 16B, BRONX, NY 10475-1802
(718) 379-1290
(718) 379-8597
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F420329-1
NY
Other
Enumeration date
10/19/2010
Last updated
10/19/2010
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