# LIFE REIMAGINED LLC

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

## Provider details

- **NPI number:** 1558141606
- **Authorized official:** KIMBERLY A SPIVEY FNP (OWNER)
- **Authorized official phone:** (931) 345-3968

## Contact information

- **Practice address:** 3380 WALNUT GROVE RD, SPARTA, TN 38583-5365
- **Practice address phone:** (931) 345-3968
- **Practice address fax:** (931) 208-3484
- **Mailing address:** 5247 VILLAGE RD, COOKEVILLE, TN 38506-7179
- **Mailing address phone:** (931) 345-3968
- **Mailing address fax:** (931) 208-3484

## Taxonomy

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

## Other

- **Enumeration date:** 10/04/2023
- **Last updated:** 10/10/2023