Organization
LODEBAR HEALTH AND WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUELA C CONSEILLANT NP-BC (PROVIDER)
(229) 234-9695
Entity
Organization
Contact information
Practice address
2945 STONE HOGAN CONNECTOR RD SW STE 205, ATLANTA, GA 30331-2839
(229) 234-9695
Mailing address
2945 STONE HOGAN CONNECTOR RD SW STE 205, ATLANTA, GA 30331-2839
(404) 343-1846
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/24/2025
Last updated
02/24/2025
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