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General NPI Number Information
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NPI Number | 1548183023
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Entity Type | Organization
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Legal Business Name | SUSTAIN HEALTH AND WELLNESS, LLC
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 62 PARKLANE CIR
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City | BETTENDORF
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State | IA
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Zip | 52722-3640
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Country | US
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Telephone | 563-593-5771
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Fax | 563-726-7697
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Provider Business Mailing Address
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Address Line | 30 N GOULD ST STE N
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City | SHERIDAN
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State | WY
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Zip | 82801-6317
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Country | US
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Telephone | 563-593-5771
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Fax | 563-726-7697
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Authorized Official
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Title or Position | ARNP
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Name | KIMBERLY ANN LOGSDON
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Credential | FNP-C
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Telephone | 563-593-5771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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