Healthcare Provider Details

I. General information

NPI: 1003401233
Provider Name (Legal Business Name): WELLNESS NASHVILLE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COVEY DR STE 309
FRANKLIN TN
37067-5663
US

IV. Provider business mailing address

618 GRASSMERE PARK STE 12A
NASHVILLE TN
37211-3643
US

V. Phone/Fax

Practice location:
  • Phone: 615-970-7884
  • Fax:
Mailing address:
  • Phone: 615-815-1754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAN BRAMLET
Title or Position: TREASURER
Credential:
Phone: 615-294-1852