# LIVE WELL PRIMARY CARE

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

## Provider details

- **NPI number:** 1952811267
- **Authorized official:** DATANYA YVETTS BETTS FNP (CEO)
- **Authorized official phone:** (919) 803-4188

## Contact information

- **Practice address:** 4064 BARRETT DR UNIT 9A, RALEIGH, NC 27609-6604
- **Practice address phone:** (919) 803-4188
- **Mailing address:** 4064 BARRETT DR UNIT 9A, RALEIGH, NC 27609-6604
- **Mailing address phone:** (919) 803-4188

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 5006305 | NC | Yes |

## Other

- **Enumeration date:** 10/02/2017
- **Last updated:** 07/01/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1639501539 | — | NC |