Organization
THE WELL FOR HEALTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE MUDGE PARKS NP (NURSE PRACTITIONER)
(704) 577-4630
Entity
Organization
Contact information
Practice address
575 DAVIDSON GATEWAY DR STE 100, DAVIDSON, NC 28036
(704) 799-5433
(704) 706-2446
Mailing address
575 DAVIDSON GATEWAY DR STE 100, DAVIDSON, NC 28036-7036
(704) 799-5433
(704) 706-2446
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
940100
NC
Other
Enumeration date
11/08/2011
Last updated
12/18/2019
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