OrganizationActive
Wellspring Weight & Wellness LLC
NPI 1043056260 · Primary Care Nurse Practitioner · Shelley, ID
Provider details
- NPI number
- 1043056260
- Entity type
- Organization
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Thomas George, Clinical Director(240) 308-1771
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
555 W Oak St Ste 1
Shelley, ID 83274-1161
Phone: (986) 249-7537
Approximate (ZIP-level) locationGet directions
Mailing address
555 W Oak St Ste 1
Shelley, ID 83274-1161
Registry dates
- Enumerated
- 2024-07-08
- Last updated
- 2024-07-08
- Certified
- 2024-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.