Provider Demographics
NPI:1104562768
Name:EVN HEALTH AND WELLNESS MANAGEMENT LLC
Entity type:Organization
Organization Name:EVN HEALTH AND WELLNESS MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:L
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:CPBT, CPIV
Authorized Official - Phone:877-552-3311
Mailing Address - Street 1:1440 SUNNY GLEN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75232-1124
Mailing Address - Country:US
Mailing Address - Phone:877-552-3311
Mailing Address - Fax:
Practice Address - Street 1:1440 SUNNY GLEN DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75232-1124
Practice Address - Country:US
Practice Address - Phone:877-552-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXCELLENT PHLEBOTOMY LAB SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care