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General NPI Number Information
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NPI Number | 1821349895
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Entity Type | Organization
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Legal Business Name | LIFE HEALTH AND WELLNESS HEALTH CARE
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Dates
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Enumeration Date | 10/01/2012
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 5040 N 15TH AVE STE 105
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City | PHOENIX
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State | AZ
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Zip | 85015-3329
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Country | US
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Telephone | 888-958-5736
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Fax | 888-958-5737
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Provider Business Mailing Address
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Address Line | PO BOX 974
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City | GLENDALE
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State | AZ
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Zip | 85311-0974
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Country | US
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Telephone | 888-958-5736
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Fax | 888-958-5737
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BEVERLY THOMAS-CARTER
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Credential | DNP,FNP-BC
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Telephone | 888-958-5736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP 3114
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP1705
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP1707
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License Number State | AZ
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