Provider Demographics
NPI:1982435301
Name:WIND HORSE CROSSING PLLC
Entity type:Organization
Organization Name:WIND HORSE CROSSING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:WAITE-O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:760-275-8598
Mailing Address - Street 1:423 E MCKINNEY AVE
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37857-3339
Mailing Address - Country:US
Mailing Address - Phone:760-275-8598
Mailing Address - Fax:423-500-0119
Practice Address - Street 1:423 E MCKINNEY AVE
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37857-3339
Practice Address - Country:US
Practice Address - Phone:760-275-8598
Practice Address - Fax:423-500-0119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health