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Organization

ALIVE HEALTH & WELLNESS

Active
Other names
Revive Health & Wellness
Organization subpart
No

Provider details

NPI number
Authorized official
JENEA BENNETT-TALLEY APRN, DNP, FNP-C (NURSE PRACTITIONER)
(804) 636-3918
Entity
Organization

Contact information

Practice address
6804 WOODLAKE COMMONS LOOP, MIDLOTHIAN, VA 23112-2281
(804) 636-3918
(804) 331-6173
Mailing address
6804 WOODLAKE COMMONS LOOP, MIDLOTHIAN, VA 23112-2281
(804) 636-3918
(804) 331-6173

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Enumeration date
09/18/2023
Last updated
09/18/2023
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