| Organization Name: | PREMIER HEALTH & WELLNESS GROUP, LLC |
| NPI Number: | 1013313774 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LANNIE B PINO (OWNER/CFNP) |
| Mailing Address: | 17188 Airline Hwy Ste D Prairieville |
| State: | LA US |
| Postal Code: | 707693443 |
| Phone Number: | 2256734900 |
| Fax Number: | 2256733338 |
| NPI Enumeration Date: | 11/07/2014 |
| NPI Last Update Date: | 11/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP04341 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |