Provider Demographics
NPI:1154182905
Name:TENDER HEART NP IN FAMILY HEALTH WELLNESS
Entity type:Organization
Organization Name:TENDER HEART NP IN FAMILY HEALTH WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER-COLE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:917-664-2932
Mailing Address - Street 1:23009 EDGEWOOD AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:LAURELTON
Mailing Address - State:NY
Mailing Address - Zip Code:11413-3605
Mailing Address - Country:US
Mailing Address - Phone:917-664-2932
Mailing Address - Fax:
Practice Address - Street 1:1975 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4025
Practice Address - Country:US
Practice Address - Phone:917-664-2932
Practice Address - Fax:929-290-0328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty