B & G Wellness INC
Nurse Practitioner, Family in Dexter, MI. Organization (NPI-2).
NPI number1962017780
StatusActive
Last updated in NPPESJan 28, 2023
Details
- NPI
- 1962017780
- Entity type
- Organization (NPI-2)
- Legal business name
- B & G Wellness INC
- Organization subpart
- No
- Enumeration date
- Sep 9, 2020
- Certification date
- Jan 28, 2023
- Last updated
- Jan 28, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Other names
- B & G Clinical Services INC (Former Legal Business Name)
Practice location
4848 Gregory Rd Ste ADexter, MI 48130-9628
Phone 734-726-5421 · Fax 949-543-2300
Mailing address
4848 Gregory Rd Ste ADexter, MI 48130-9628
Phone 734-726-5421 · Fax 949-543-2300
Authorized official
Julie Bumpus
Owner
7347308445
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