Provider Demographics
NPI:1881282937
Name:ELITE HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:ELITE HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:STICKNEY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:308-455-1500
Mailing Address - Street 1:2401 E AVE UNIT 3077
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-0347
Mailing Address - Country:US
Mailing Address - Phone:308-455-1500
Mailing Address - Fax:308-455-1502
Practice Address - Street 1:4715 2ND AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2463
Practice Address - Country:US
Practice Address - Phone:308-455-1500
Practice Address - Fax:308-455-1502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty