Provider Demographics
NPI:1487315131
Name:FIRE WEIGHT LOSS AND WELLNESS OF NYC
Entity type:Organization
Organization Name:FIRE WEIGHT LOSS AND WELLNESS OF NYC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC, FNP-
Authorized Official - Phone:972-729-9010
Mailing Address - Street 1:1617 BEAUREGARD POINT DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-8509
Mailing Address - Country:US
Mailing Address - Phone:972-729-9010
Mailing Address - Fax:469-947-6767
Practice Address - Street 1:1151 N BUCKNER BLVD STE 407
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3407
Practice Address - Country:US
Practice Address - Phone:972-729-9010
Practice Address - Fax:469-947-6767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-05
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty