Organization
LIFTUP LIVEWELL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NERISA BRYAN APN (OWNER)
(212) 918-4488
Entity
Organization
Contact information
Practice address
111 TOWN SQUARE PL STE 803054, JERSEY CITY, NJ 07310-1755
(212) 918-4488
Mailing address
111 TOWN SQUARE PL STE 803054, JERSEY CITY, NJ 07310-1755
(212) 918-4488
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/10/2023
Last updated
11/29/2023
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