Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

SOURCE FOUNTAIN WELLNESS LLC
NPI 1750290110
Nurse Practitioner - Psychiatric/Mental Health in Fredericksburg, VA

Q: What is Source Fountain Wellness LLC's NPI number?

The NPI number for Source Fountain Wellness LLC is 1750290110. It was assigned to this organization in the NPPES registry on September 2, 2026.

Q: What is Source Fountain Wellness LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since September 02, 2026

105 BANCROFT DR, FREDERICKSBURG, VA 22405(706) 589-6211(450) 371-3016 Get Directions Write a Review

NPPES record added: September 2, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

On this page

About Source Fountain Wellness Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOURCE FOUNTAIN WELLNESS LLC (NPI 1750290110) is a healthcare organization registered as a psychiatric/mental health in Fredericksburg, Virginia and active in the NPI registry since September 2026. The organization lists Yvonne Anutatu Nkeze, Owner, as its authorized official.

NPPES Registry Identity

NPI1750290110

Entity TypeOrganization

Primary Taxonomy363LP0808X

Legal Business NameSOURCE FOUNTAIN WELLNESS LLC

Location Address105 BANCROFT DRFredericksburg, VA 22405-1206

Mailing Address105 Bancroft DrFredericksburg, VA 22405-1206 · (706) 589-6211 · Fax (450) 371-3016

Phone(706) 589-6211

Fax(450) 371-3016

Organization SubpartNo

Authorized OfficialYvonne Anutatu NkezeOwner · (706) 589-6211

Enumeration DateSeptember 2, 2026

NPPES CertifiedSeptember 2, 2026

✔ NPI 1750290110 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

105 BANCROFT DR, Fredericksburg, VA 22405

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Source Fountain Wellness LLC's NPI number?

The NPI number for Source Fountain Wellness LLC is 1750290110. It was assigned to this organization in the NPPES registry on September 2, 2026.

Where is Source Fountain Wellness LLC located?

Source Fountain Wellness LLC is located at 105 Bancroft Dr, Fredericksburg, VA 22405. The listed phone number is (706) 589-6211.

What is Source Fountain Wellness LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Source Fountain Wellness LLC was last updated on September 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.