ALIVE HEALTH AND WELLNESS LLC NPI 1053011452

NPI Information

NPI: 1053011452
Provider Name: ALIVE HEALTH AND WELLNESS LLC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D2284054

Address:
377 W PIKE ST STE A3
LAWRENCEVILLE, GA
ZIP 30046
Phone: (470) 523-5570
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ALIVE HEALTH AND WELLNESS LLC is a primary care nurse practitioner in Lawrenceville, GA. ALIVE HEALTH AND WELLNESS LLC NPI is 1053011452. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

377 W PIKE ST STE A3
LAWRENCEVILLE, GA
ZIP 30046-206
Phone: (470) 523-5570

The provider's authorized official is Esther Sweetheart Gensinger .
The authorized official title is Owner/authorized Official and has the following contact phone number (470) 523-5570.

The CLIA number assigned to this NPI record is 11D2284054 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/6/2023 and was last updated on 3/24/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RI0001X	Internal Medicine	Clinical & Laboratory Immunology			No
2	363LP2300X	Nurse Practitioner	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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