# EXECUTIVE LEVEL WELLNESS

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

## Provider details

- **NPI number:** 1841698123
- **Authorized official:** DAVID HUGHES NP (OWNER)
- **Authorized official phone:** (731) 571-8808

## Contact information

- **Practice address:** 1167 JR JONES RD, HUMBOLDT, TN 38343-8080
- **Practice address phone:** (731) 431-2818
- **Practice address fax:** (888) 318-1702
- **Mailing address:** 1167 JR JONES RD, HUMBOLDT, TN 38343
- **Mailing address phone:** (731) 431-2818
- **Mailing address fax:** (888) 318-1702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 364SG0600X | Gerontology Clinical Nurse Specialist | APN013215 | TN | Yes |

## Other

- **Enumeration date:** 12/18/2014
- **Last updated:** 12/18/2014