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General NPI Number Information
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NPI Number | 1740129840
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Entity Type | Organization
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Legal Business Name | LONGEVITY PSYCHIATRIC HEALTH & WELLNESS,LLC
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Dates
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Enumeration Date | 03/25/2026
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Last Update Date | 03/25/2026
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Provider Practice Location Address
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Address Line | 122 NICKOLAS CIR
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City | LEBANON
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State | TN
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Zip | 37087-1380
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Country | US
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Telephone | 629-276-3917
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Fax | 629-910-9416
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Provider Business Mailing Address
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Address Line | 122 NICKOLAS CIR
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City | LEBANON
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State | TN
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Zip | 37087-1380
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Country | US
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Telephone | 629-276-3917
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Fax | 629-910-9416
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Authorized Official
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Title or Position | OWNER
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Name | MARGARET OLIVER
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Credential | APN
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Telephone | 629-276-3917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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