Provider Demographics
NPI:1194441865
Name:NEW HOPE WELLNESS CLINIC PLLC
Entity type:Organization
Organization Name:NEW HOPE WELLNESS CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:C
Authorized Official - Last Name:WILLETT
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:919-887-0084
Mailing Address - Street 1:202 EAST RALEIGH STREET
Mailing Address - Street 2:STE C
Mailing Address - City:SILVER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-3558
Mailing Address - Country:US
Mailing Address - Phone:919-887-0084
Mailing Address - Fax:919-887-0180
Practice Address - Street 1:202 EAST RALEIGH STREET
Practice Address - Street 2:STE C
Practice Address - City:SILVER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-3558
Practice Address - Country:US
Practice Address - Phone:919-887-0084
Practice Address - Fax:919-887-0180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty