# WELLNESS CONNECT GO BEYOND MEDICINE, LLC

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

## Provider details

- **NPI number:** 1487203303
- **Authorized official:** MIRIANNYS RIVAS FNP-C (FNP-C)
- **Authorized official phone:** (401) 642-0100

## Contact information

- **Practice address:** 655 BROAD ST STE 201, PROVIDENCE, RI 02907-1444
- **Practice address phone:** (401) 642-0100
- **Practice address fax:** (833) 992-2318
- **Mailing address:** 655 BROAD ST STE 201, PROVIDENCE, RI 02907-1444
- **Mailing address phone:** (401) 642-0100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207VG0400X | Gynecology Physician | — | NULL | — |
| 207VG0400X | Gynecology Physician | — | — | — |
| 251E00000X | Home Health Agency | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/04/2019
- **Last updated:** 01/24/2024