Provider Demographics
NPI:1407541915
Name:INSPIRE HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:INSPIRE HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLIE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:662-262-8441
Mailing Address - Street 1:7105 SWINNEA RD
Mailing Address - Street 2:STE 3 BOX 5
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671
Mailing Address - Country:US
Mailing Address - Phone:662-262-8441
Mailing Address - Fax:662-996-0198
Practice Address - Street 1:7105 SWINNEA RD STE 3
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-6012
Practice Address - Country:US
Practice Address - Phone:662-262-8441
Practice Address - Fax:662-996-0198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service