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General NPI Number Information
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NPI Number | 1346199957
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Entity Type | Organization
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Legal Business Name | 513 VITALITY HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 01/26/2026
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 30 AMERICAN WAY STE 1
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City | MONROE
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State | OH
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Zip | 45050-1243
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Country | US
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Telephone | 865-292-3779
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Fax |
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Provider Business Mailing Address
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Address Line | 6760 RIVERVIEW AVE
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City | MIDDLETOWN
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State | OH
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Zip | 45042-3100
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Country | US
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Telephone | 865-292-3779
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Fax |
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Authorized Official
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Title or Position | OWNER, NURSE PRACTITIONER
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Name | SHAWNEE HUNT
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Credential | CNP
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Telephone | 865-292-3779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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