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Organization
LIFESPAN WELLNESS PLLC
Active
Organization
LIFESPAN WELLNESS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REBEKAH DANIELLE NATION APRN (OWNER/PSYCHIATRIC NP)
(770) 324-7635
Entity
Organization
Contact information
Practice address
1404 N MAIN ST, SUITE 101, MERIDIAN, ID 83642-2799
(208) 888-6264
(208) 906-2363
Mailing address
1404 N MAIN ST, SUITE 101, MERIDIAN, ID 83642-2799
(208) 888-6264
(208) 906-2363
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP-1536A
ID
Other
Enumeration date
08/25/2015
Last updated
02/24/2016
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