Organization
LIVEWELL HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI MICHELLE GOSS CNP (NURSE PRACTITIONER)
(208) 571-1060
Entity
Organization
Contact information
Practice address
11517 W SHARPTHORN ST, BOISE, ID 83709-6784
(208) 571-1060
Mailing address
11517 W SHARPTHORN ST, BOISE, ID 83709-6784
(208) 571-1060
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/05/2023
Last updated
12/05/2023
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