Provider Demographics
NPI:1003401233
Name:WELLNESS NASHVILLE PLLC
Entity Type:Organization
Organization Name:WELLNESS NASHVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAMLET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-294-1852
Mailing Address - Street 1:618 GRASSMERE PARK STE 12A
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-3643
Mailing Address - Country:US
Mailing Address - Phone:615-815-1754
Mailing Address - Fax:
Practice Address - Street 1:100 COVEY DR STE 309
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5663
Practice Address - Country:US
Practice Address - Phone:615-970-7884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder