NPI Profile for ALIVE HEALTH AND WELLNESS LLC in LAWRENCEVILLE, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner | |
Clinical & Laboratory Immunology |
207RI0001X | 11 | Physician/Internal Medicine |
| NPI # | 1053011452 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 03/06/2023 | |
| Last updated | 03/24/2023 - About 3 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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ALIVE HEALTH AND WELLNESS LLC
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