Provider Demographics
NPI:1487906483
Name:EMPLOYEE WELLNESS ALLIANCE
Entity type:Organization
Organization Name:EMPLOYEE WELLNESS ALLIANCE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BUFFIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-953-9940
Mailing Address - Street 1:13800 NICOLLET BLVD
Mailing Address - Street 2:SUITE 2252
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-6100
Mailing Address - Country:US
Mailing Address - Phone:952-953-9940
Mailing Address - Fax:952-236-6424
Practice Address - Street 1:13800 NICOLLET BLVD
Practice Address - Street 2:SUITE 2252
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-6100
Practice Address - Country:US
Practice Address - Phone:952-953-9940
Practice Address - Fax:952-236-6424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-15
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILAAMA 2384367246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty