| Wellmood Pllc | |
|
717 S Marshall St Ste 204 Winston Salem NC 27101-5865 | |
| (336) 739-4379 | |
| Not Available |
| Full Name | Wellmood Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 717 S Marshall St Ste 204, Winston Salem, North Carolina |
| Authorized Official Name and Position | Kellie L Newsome (PROVIDER) |
| Authorized Official Contact | 3367394379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellmood Pllc 717 S Marshall St Ste 204 Winston Salem NC 27101-5865 Ph: (336) 739-4379 | Wellmood Pllc 717 S Marshall St Ste 204 Winston Salem NC 27101-5865 Ph: (336) 739-4379 |
| NPI Number | 1154182368 |
|---|---|
| Provider Enumeration Date | 01/16/2024 |
| Last Update Date | 08/14/2024 |
| Certification Date | 08/14/2024 |
| Medicare PECOS PAC ID | 3779025192 |
|---|---|
| Medicare Enrollment ID | O20240612003376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154182368 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kellie L Newsome |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649718180 PECOS PAC ID: 2062843238 Enrollment ID: I20200504002243 |
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