Heritage Wellness Center, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

HERITAGE WELLNESS CENTER, LLC

Doing business as

Heritage Wellness Center, LLC

Practice address

92 W Lowder St
Macclenny, FL 32063-2676

Phone

(904) 259-0092

Fax

(904) 259-0094

NPI assigned

Aug 3, 2023

Last updated

Aug 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Claudette Michelle Mallory, APRNNPI 1679547442

Title

Nurse Practitioner

Phone

(904) 259-0092

Specialties & licenses 1

Addresses

Other names 1

• Heritage Wellness Center, LLC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Claudette M Mallory, APRN

  • Family Nurse Practitioner
  • Macclenny, FL
  • NPI 1679547442
  Authorized official Same address or phone

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

{
    "created_epoch": "1691020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1952083495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 W LOWDER ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632676",
            "telephone_number": "904-259-0092",
            "fax_number": "904-259-0094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 W LOWDER ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632676",
            "telephone_number": "904-259-0092",
            "fax_number": "904-259-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-03",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "MALLORY",
        "authorized_official_first_name": "CLAUDETTE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "904-259-0092",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Wellness Center, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Michelle Harvey, MSN, APRN, FNP-C
• Linda Louise Heilman, ARNP
• Delaney Helms
• Cathy A Henderson, ARNP, MSN, PCCN
• Kammi Mignon Henderson, PHARM.D.
• Trevor D Hicks, APRN
• Cam Hoang, M.D
• Holiday CVS LLC (CVS Pharmacy #07980)
• Kylie Amber Holton
• Hometown Home Health LLC

• Family Nurse Practitioner in Macclenny, FL
• Providers in Macclenny, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.