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Organization
GENESIS WELLNESS CENTER PLLC
Active
Organization
GENESIS WELLNESS CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA C GAINES APRN (OWNER)
(502) 644-9162
Entity
Organization
Contact information
Practice address
3000 S 5TH ST, LOUISVILLE, KY 40208-1312
(502) 644-9162
(502) 390-0330
Mailing address
4507 MEADOWLARK MANOR LN, LOUISVILLE, KY 40245-2702
(502) 644-9162
(502) 390-0330
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
—
NULL
363LC1500X
Community Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/20/2023
Last updated
07/11/2024
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