Provider Demographics
NPI:1942030473
Name:ENFUSE HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:ENFUSE HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SIDONIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-599-9346
Mailing Address - Street 1:13 KAREN CT
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-5171
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1201 PHILADELPHIA PIKE STE D
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-2043
Practice Address - Country:US
Practice Address - Phone:302-599-9346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty