# ALIVE & WELL LLC

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

## Provider details

- **NPI number:** 1497526198
- **Authorized official:** DONNA J WILSON APRN (APRN, OWNER)
- **Authorized official phone:** (270) 216-2212

## Contact information

- **Practice address:** 110 W MAIN CROSS ST, GREENVILLE, KY 42345-1202
- **Practice address phone:** (270) 216-2212
- **Practice address fax:** (270) 297-8311
- **Mailing address:** 908 E BROAD ST, CENTRAL CITY, KY 42330-1532
- **Mailing address phone:** (270) 216-2212
- **Mailing address fax:** (270) 297-8311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/11/2024
- **Last updated:** 01/11/2024