Organization
LIVE WELL HEALTHCARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ENYONAM JORDAN-BRANGMAN NP (NURSE PRACTITIONER)
(571) 247-4434
Entity
Organization
Contact information
Practice address
20130 LAKEVIEW CENTER PLZ STE 400, ASHBURN, VA 20147-5905
(571) 931-2533
(571) 365-7530
Mailing address
20130 LAKEVIEW CENTER PLZ STE 400, ASHBURN, VA 20147-5905
(571) 931-2533
(571) 365-7530
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/16/2023
Last updated
01/30/2026
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