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Organization

GENESIS WELLNESS CENTER PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LISA C GAINES APRN (OWNER)
(502) 644-9162
Entity
Organization

Contact information

Practice address
3000 S 5TH ST, LOUISVILLE, KY 40208-1312
(502) 644-9162
(502) 390-0330
Mailing address
4507 MEADOWLARK MANOR LN, LOUISVILLE, KY 40245-2702
(502) 644-9162
(502) 390-0330

Taxonomy

Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
363LF0000X
Family Nurse Practitioner
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
11/20/2023
Last updated
07/11/2024
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