Provider Demographics
NPI:1679290977
Name:VIP WELLCARE PLLC
Entity type:Organization
Organization Name:VIP WELLCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLINGSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:602-885-2495
Mailing Address - Street 1:29455 N CAVE CREEK RD STE 118-520
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-3245
Mailing Address - Country:US
Mailing Address - Phone:602-888-1420
Mailing Address - Fax:
Practice Address - Street 1:29455 N CAVE CREEK RD STE 118-520
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-3245
Practice Address - Country:US
Practice Address - Phone:602-888-1420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty