# LIVEWELL HEALTH AND WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184491755
- **Authorized official:** VICKI MICHELLE GOSS CNP (NURSE PRACTITIONER)
- **Authorized official phone:** (208) 571-1060

## Contact information

- **Practice address:** 11517 W SHARPTHORN ST, BOISE, ID 83709-6784
- **Practice address phone:** (208) 571-1060
- **Mailing address:** 11517 W SHARPTHORN ST, BOISE, ID 83709-6784
- **Mailing address phone:** (208) 571-1060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/05/2023
- **Last updated:** 12/05/2023