Provider Demographics
NPI:1992549828
Name:WELLNESS IN MOTION 4 LIFE: A STRONG MIND EQUALS A STRONG BODY, PLLC
Entity type:Organization
Organization Name:WELLNESS IN MOTION 4 LIFE: A STRONG MIND EQUALS A STRONG BODY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:AKELAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODY
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC, FNP-BC
Authorized Official - Phone:919-617-1307
Mailing Address - Street 1:4819 EMPEROR BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-5420
Mailing Address - Country:US
Mailing Address - Phone:919-617-1307
Mailing Address - Fax:
Practice Address - Street 1:4819 EMPEROR BLVD STE 400
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-5420
Practice Address - Country:US
Practice Address - Phone:919-617-1307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty