Healthcare Provider Details

I. General information

NPI: 1003752999
Provider Name (Legal Business Name): INTENTION HOLISTIC HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 TOBACCO RD
MURRAY KY
42071-6956
US

IV. Provider business mailing address

237 TOBACCO RD
MURRAY KY
42071-6956
US

V. Phone/Fax

Practice location:
  • Phone: 270-238-0813
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALICIA HARRISON
Title or Position: OWNER, NURSE PRACTITIONER
Credential: APRN FNP-C
Phone: 270-238-0813