Organization
ALIVE & WELL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA J WILSON APRN (APRN, OWNER)
(270) 216-2212
Entity
Organization
Contact information
Practice address
110 W MAIN CROSS ST, GREENVILLE, KY 42345-1202
(270) 216-2212
(270) 297-8311
Mailing address
908 E BROAD ST, CENTRAL CITY, KY 42330-1532
(270) 216-2212
(270) 297-8311
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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