NPIMap

Organization Active NPI

Nurse Practitioner Women's Health, PLLC

  • Women's Health Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1568772952
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
F420329-1 Issued in NY
Legal business name
NURSE PRACTITIONER WOMEN'S HEALTH, PLLC
Practice address
140 Darrow PL
Suite 16B
Bronx, NY 10475-1802
Phone
(718) 379-1290
Fax
(718) 379-8597
NPI assigned
Oct 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Authorized official

Name
Ms. Johnetta Miner, NP
Title
Ceo/President
Phone
(718) 379-1290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LW0102X F420329-1 NY Primary

Addresses

Primary practice location

140 Darrow PL
Suite 16B
Bronx, NY 10475-1802

Mailing address

140 Darrow PL
Suite 16B
Bronx, NY 10475-1802
Phone (718) 379-1290

Other names 1

  • Lifestyle Wellness Enterprise, PLLC Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1568772952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 DARROW PL",
            "address_2": "SUITE 16B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104751802",
            "telephone_number": "718-379-1290",
            "fax_number": "718-379-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 DARROW PL",
            "address_2": "SUITE 16B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104751802",
            "telephone_number": "718-379-1290",
            "fax_number": "718-379-8597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSE PRACTITIONER WOMEN'S HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "MINER",
        "authorized_official_first_name": "JOHNETTA",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "17183791290",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NY",
            "license": "F420329-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifestyle Wellness Enterprise, PLLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.