Organization
ENRICHED WELLNESS NURSING CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWANDA SMITH NP (CEO)
(323) 379-4374
Entity
Organization
Contact information
Practice address
11901 AVALON BLVD, LOS ANGELES, CA 90061-2836
(323) 379-4371
Mailing address
915 E 94TH ST, LOS ANGELES, CA 90002-1912
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
Other
Enumeration date
06/29/2022
Last updated
01/20/2024
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