Provider Demographics
NPI:1821387515
Name:ASCENSION HEALTH AND WELLNESS, LLC
Entity Type:Organization
Organization Name:ASCENSION HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BEAUREGARD
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, ANP-BC
Authorized Official - Phone:615-772-4789
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-0102
Mailing Address - Country:US
Mailing Address - Phone:615-772-4789
Mailing Address - Fax:
Practice Address - Street 1:6032 CHRISTMAS DR
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-7458
Practice Address - Country:US
Practice Address - Phone:615-772-4789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-03
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15399363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty