Provider Demographics
NPI:1073215703
Name:ORCHID WELLNESS, PLLC
Entity type:Organization
Organization Name:ORCHID WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:AMOAFI
Authorized Official - Last Name:DEBRAH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:469-892-0194
Mailing Address - Street 1:3620 N JOSEY LN STE 117
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-3157
Mailing Address - Country:US
Mailing Address - Phone:469-892-0194
Mailing Address - Fax:469-942-7172
Practice Address - Street 1:3620 N JOSEY LN STE 117
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-3157
Practice Address - Country:US
Practice Address - Phone:469-892-0194
Practice Address - Fax:469-942-7172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care