Organization · Type 2 NPI

Omni Wellness Group LLC

Psychiatric/Mental Health Nurse Practitioner · Troy, OH

NPI number 1861982423 Active

Practice location

1149 Experiment Farm Road
Troy, OH 45373

Call (937) 540-9920 Map

Fax (937) 202-0213

Mailing address

1149 Experiment Farm Rd
Troy, OH 45373-1071

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Psychiatric/Mental Health Nurse Practitioner Primary	363LP0808X	None listed

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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NPI record

NPI: 1861982423
Entity type: Organization (Type 2)
Issued: May 18, 2018
Last updated: Oct 30, 2023
Status: Active

Other names

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Omni Wellness Group · former legal business name
Omni Wellness Group · former legal business name

Authorized official

Sheila Petrequin
Billing Manager
(937) 438-9500

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1861982423

Omni Wellness Group LLC's National Provider Identifier is 1861982423, issued on May 18, 2018. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Troy, OH. The record was last updated on Oct 30, 2023.