Presque Isle Mind-Body Wellness Center, PLLC

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

Legal business name

PRESQUE ISLE MIND-BODY WELLNESS CENTER, PLLC

Practice address

2500 Palermo Dr
Erie, PA 16506-7206

Phone

(814) 860-3179

Fax

(814) 616-7400

NPI assigned

Nov 5, 2019

Organization subpart

No

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

Authorized official

Name

Kelly Weary

Title

Manager

Phone

(814) 860-3179

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644883200000",
    "number": "1467096164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 PALERMO DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165067206",
            "telephone_number": "814-860-3179",
            "fax_number": "814-616-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 PALERMO DR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165067206",
            "telephone_number": "814-860-3179",
            "fax_number": "814-616-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESQUE ISLE MIND-BODY WELLNESS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-05",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A",
        "authorized_official_last_name": "WEARY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "814-860-3179"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Presbyterian Homes in the Presbytery of Lake Erie
• Presbyterian Homes in the Presbytery of Lake Erie
• Pamela Ann Presler, M.S.W., L.C.S.W.
• Presque Isle Colon and Rectal Surgery
• Presque Isle Family Medicine
• Presque Isle Optique LLC (Council Optometric Center)
• Presque Isle Orthopedic Laboratory Inc.
• Presque Isle Psychiatric Associates
• Nicholas J Price
• Cynthia Ann Priester, MS, OTR-L

• Adult Psychiatric/Mental Health Registered Nurse in Erie, PA
• Providers in Erie, PA by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.