OrganizationActive
Integrative Core Wellness, LLC
NPI 1902784820 · Primary Care Nurse Practitioner · Manchester, CT
Provider details
- NPI number
- 1902784820
- Entity type
- Organization
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Vanessa Bolling, Ceo(860) 995-2645
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
112 Spencer St Ste 2a
Manchester, CT 06040-4601
Phone: (860) 797-0163
Fax: (978) 672-5448
Street-level locationGet directions
Mailing address
112 Spencer St Ste 2a
Manchester, CT 06040-4601
Registry dates
- Enumerated
- 2025-08-27
- Last updated
- 2025-08-27
- Certified
- 2025-08-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.