LIFESPAN WELLNESS LLC (NPI# 1568949097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568949097 |
| Entity Type | Organization |
| Organization Name | LIFESPAN WELLNESS LLC |
| Practice Address |
101 Rouselle Pl Ste A Ocean Springs MS 39564-3074 |
| Practice Telephone | 2283278210 |
| Mailing Telephone | 2283278210 |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2018-07-27 |
| Authorized Official Name | RENATA HOLLIMAN (MANAGER) |
| Authorized Official Telephone | 2514221979 |
| Authorized Official Credential | FNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
1127426 | MS | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790180743 | Lifespan Wellness LLC | Community/Behavioral Health | 8200 Mountain Rd Ne Ste 101, Albuquerque, NM 87110-7835 | 2014-11-01 |
| Street Address |
101 ROUSELLE PL STE A |
| City | OCEAN SPRINGS |
| State | MS |
| Zip Code | 39564-3074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750996401 | Shelby Bourgeois | Speech-Language Pathologist | 108 Heron Park Pl, Ocean Springs, MS 39564 | 2020-09-10 |
| 1467010520 | Rachel Stephenie Knox | Student in an Organized Health Care Education/Training Program | 81mdss/gme 301 Fisher St., Rm 1g123, Keesler Afb, MS 39564 | 2019-06-04 |
| 1457839292 | Polly Anne Lampon | Registered Nurse | 2301 Rue Beaux Chenes, Ocean Springs, MS 39564 | 2018-08-03 |
| 1578062725 | Gulf Coast Sleep Medicine LLC | Clinic/Center | 2112 Bienville Blvd., Suite P, Ocean Springs, MS 39564 | 2018-02-02 |
| 1598212623 | Edward Victor Brown Jr. | Dentist | 15465 Oak Lane, Gulfport, MS 39564 | 2016-09-07 |
| 1386016749 | L. Randy Buntyn, D.m.d., Pllc | Dentist | 1203 Government St., Ocean Springs, MS 39564 | 2015-10-26 |
| 1467835629 | Msmobileyes Inc. | Optometrist | 2510 Bileville Blvd, Ocean Springs, MS 39564 | 2015-07-07 |
| 1659760999 | Clark Jamison Levi | Pharmacist | 1019 Government Street Suite F & D, Ocean Springs, MS 39564 | 2015-01-09 |
| 1932545480 | Therese Anne Hanna | Nurse Practitioner | 6900 Washington Avenue, Ocean Springs, MS 39564 | 2013-05-10 |
| 1346589421 | Jennah Claine Ladner | Nurse Practitioner | 1137 Ocean Springs Road, Ocean Springs, MS 39564 | 2013-02-08 |
| Find all providers in zip 39564 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215322987 | Day To Day Nutrition, LLC | Clinic/Center | 1911 Stuart Ave, Ocean Springs, MS 39564-3925 | 2015-03-31 |
| 1205083110 | James B Martin Md LLC | Clinic/Center | 1103 Hanley Rd, Ocean Springs, MS 39564-3108 | 2008-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303010 | Northwest Health and Wellness, Inc | Clinic/Center | 215 Northwest Drive, Senatobia, MS 38668 | 2020-10-12 |
| 1538786090 | Essential Health & Wellness Clinic P.a. | Clinic/Center | 5842 Goodman Rd Ste 1, Horn Lake, MS 38637-8106 | 2020-07-01 |
| 1144841826 | Love and Care Adult Daycare and Personal Care Services | Clinic/Center | 521 Brentwood Ave, Greenwood, MS 38930-6910 | 2020-05-04 |
| 1982254389 | Lca of Ms, LLC | Clinic/Center | 6098 U S Highway 98 Ste 4, Hattiesburg, MS 39402-8878 | 2019-09-17 |
| 1841849791 | Ayanna Hawkins | Clinic/Center | 1294 White Oak Rd, Tunica, MS 38676-9743 | 2019-09-04 |
| 1003463928 | Np Professional Services, LLC | Clinic/Center | 17 Church Cv, Beulah, MS 38726-9430 | 2019-08-26 |
| 1760035232 | Mcmedical Country Clinic LLC | Clinic/Center | 52 County Road 74, Mc Carley, MS 38943-6820 | 2019-07-23 |
| 1720550775 | Karen Jackson | Clinic/Center | 104 Taggart Dr, Steens, MS 39766-9563 | 2018-12-31 |
| 1831672435 | Healthcareonthego, LLC | Clinic/Center | 3901 King Rd, Meridian, MS 39305-2533 | 2018-09-10 |
| 1013443811 | Jackson Diabetes Care and Consulting LLC | Clinic/Center | 2610 Traceland Dr Ste A, Tupelo, MS 38801-4237 | 2017-05-11 |
| Find all providers with the same taxonomy | ||||
| City | OCEAN SPRINGS |
| Zip Code | 39564 |
Please comment or provide details below to improve the information on LIFESPAN WELLNESS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.