Organization
LIFE REIMAGINED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY A SPIVEY FNP (OWNER)
(931) 345-3968
Entity
Organization
Contact information
Practice address
3380 WALNUT GROVE RD, SPARTA, TN 38583-5365
(931) 345-3968
(931) 208-3484
Mailing address
5247 VILLAGE RD, COOKEVILLE, TN 38506-7179
(931) 345-3968
(931) 208-3484
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/04/2023
Last updated
10/10/2023
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