Provider Demographics
NPI:1982445722
Name:TNJ WELLNESS LLC
Entity type:Organization
Organization Name:TNJ WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:317-590-3722
Mailing Address - Street 1:1331 H ST NW STE 200
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-4706
Mailing Address - Country:US
Mailing Address - Phone:317-590-3722
Mailing Address - Fax:202-998-1759
Practice Address - Street 1:1331 H ST NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-4706
Practice Address - Country:US
Practice Address - Phone:301-893-4353
Practice Address - Fax:202-998-1759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty