1992489439 NPI number — NATURAL GIRL HERBAL CONSULTATIONS & PRODUCTS LLC

Table of content: DR. IAN NICHOLAS WILHELM M.D. (NPI 1538427885)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992489439 NPI number — NATURAL GIRL HERBAL CONSULTATIONS & PRODUCTS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATURAL GIRL HERBAL CONSULTATIONS & PRODUCTS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992489439
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/14/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6620 CANAL BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70124-3212
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-313-2871
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3525 HESSMER AVE STE 206
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
METAIRIE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70002-6406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-313-2871
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2023

Additional Information

Authorized Official

Authorized Official Last Name:
ALLEN
Authorized Official First Name:
KOURTNEY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
504-313-2871

Provider Taxonomy Codes

  • Taxonomy code: 225700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1821702283 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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