Organization
NURSE PRACTITIONER WOMEN'S HEALTH, PLLC
Active
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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