3D Brows and Wellness LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

CLIE-AHZQT3 Issued in WI

Legal business name

3D BROWS AND WELLNESS LLC

Practice address

801 Hoffman Rd Ste 106
Green Bay, WI 54301-1462

Phone

(920) 277-6989

NPI assigned

Jun 22, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jill Marie UllmerNPI 1124756002

Title

Owner

Phone

(920) 277-6989

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jill Marie Ullmer

  • Specialist
  • Green Bay, WI
  • NPI 1124756002
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498089600000",
    "number": "1003336884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 HOFFMAN RD STE 106",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543011462",
            "telephone_number": "19202776989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 HOFFMAN RD STE 106",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543011462",
            "telephone_number": "920-277-6989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3D BROWS AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-22",
        "last_updated": "2017-06-22",
        "status": "A",
        "authorized_official_last_name": "ULLMER",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-277-6989",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "WI",
            "license": "CLIE-AHZQT3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Multi-Specialty Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.