Provider Demographics
NPI:1770375339
Name:TRANSFORMATION PRIMARY CARE AND WELLNESS CLINIC
Entity type:Organization
Organization Name:TRANSFORMATION PRIMARY CARE AND WELLNESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELILSHA
Authorized Official - Middle Name:RASHI
Authorized Official - Last Name:COLLINS JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:504-444-2395
Mailing Address - Street 1:650 POYDRAS ST STE 1400
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-6116
Mailing Address - Country:US
Mailing Address - Phone:504-221-3602
Mailing Address - Fax:
Practice Address - Street 1:6600 FRANKLIN AVE STE A2
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-5716
Practice Address - Country:US
Practice Address - Phone:504-444-2395
Practice Address - Fax:866-439-7448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty