NPI 1396602793 · live from the CMS NPI Registry
Addiction Wellness Center Va
Nurse Practitioner in Front Royal, VA. National Provider Identifier 1396602793, active.
NPI record
| NPI | 1396602793 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 824 John Marshall Hwy Ste 203, Front Royal, VA 22630 |
| Practice phone | 540-655-2936 |
| Mailing address | 1100 Business Pkwy S Ste 1, Westminster, MD 21157 |
| Enumerated | January 7, 2026 |
| Last updated | January 30, 2026 |
| Authorized official | Jessie Costley, Credentialing Specialist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner primary | 363L00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.