Pure Life Health and Wellness LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PURE LIFE HEALTH AND WELLNESS LLC

Practice address

617 E Riverside Dr Ste 104
St George, UT 84790-8720

Phone

(801) 638-7826

NPI assigned

Jan 19, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Aj Yergensen

Title

Admin

Phone

(435) 986-9369

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1003521485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 E RIVERSIDE DR STE 104",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847908720",
            "telephone_number": "801-638-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 E RIVERSIDE DR STE 104",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847908720",
            "telephone_number": "801-638-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE LIFE HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "YERGENSEN",
        "authorized_official_first_name": "AJ",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "435-986-9369"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Marie Pulica
• Pulmonary & Sleep Clinic
• Mark William Pulsipher, M.D.
• Jo Puntil-Sheltman
• Maricel Purcell, FNP
• Jack Putnam
• Jennifer M Putnam, AMFT
• Susanna R Putnam
• Cambria Quackenbush
• Cheng Quek

• Clinic/Center in St George, UT
• Providers in St George, UT by specialty
• Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.