Provider Demographics
NPI:1467840389
Name:WELLNEST, LLC
Entity Type:Organization
Organization Name:WELLNEST, LLC
Other - Org Name:CENTRAL WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEANINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-869-1066
Mailing Address - Street 1:1010 CENTRAL AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-5812
Mailing Address - Country:US
Mailing Address - Phone:406-869-1066
Mailing Address - Fax:406-869-1099
Practice Address - Street 1:1010 CENTRAL AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-5812
Practice Address - Country:US
Practice Address - Phone:406-869-1066
Practice Address - Fax:406-869-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT28537363LF0000X
MT36449363LF0000X
MT32201363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty