| Southern Health & Wellness Clinic | |
|
3519 Chere Carol Rd Humboldt TN 38343-3638 | |
| (731) 414-9051 | |
| Not Available |
| Full Name | Southern Health & Wellness Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 3519 Chere Carol Rd, Humboldt, Tennessee |
| Authorized Official Name and Position | Stephanie Thomas Boling (OWNER) |
| Authorized Official Contact | 7317845080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Health & Wellness Clinic 3519 Chere Carol Rd Humboldt TN 38343-3638 Ph: () - | Southern Health & Wellness Clinic 3519 Chere Carol Rd Humboldt TN 38343-3638 Ph: (731) 414-9051 |
| NPI Number | 1679246987 |
|---|---|
| Provider Enumeration Date | 08/01/2021 |
| Last Update Date | 08/24/2021 |
| Medicare PECOS PAC ID | 1153712062 |
|---|---|
| Medicare Enrollment ID | O20220104001934 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679246987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Stephanie T Boling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619370889 PECOS PAC ID: 8224250006 Enrollment ID: I20141111001313 |
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