Provider Demographics
NPI:1497629356
Name:VELLURA HEALTH LLC
Entity type:Organization
Organization Name:VELLURA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:RENAE
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:509-251-8920
Mailing Address - Street 1:6700 N LINDER RD STE 156A
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-6607
Mailing Address - Country:US
Mailing Address - Phone:509-251-8920
Mailing Address - Fax:208-264-9569
Practice Address - Street 1:5483 N BLACK SAND AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-5662
Practice Address - Country:US
Practice Address - Phone:509-251-8920
Practice Address - Fax:208-264-9569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service