Provider Demographics
NPI:1285456640
Name:BOLD BEGINNINGS WELLNESS
Entity type:Organization
Organization Name:BOLD BEGINNINGS WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHEYENNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GASAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, BCADM
Authorized Official - Phone:937-527-6239
Mailing Address - Street 1:10948 STATE ROUTE 73
Mailing Address - Street 2:
Mailing Address - City:NEW VIENNA
Mailing Address - State:OH
Mailing Address - Zip Code:45159-9524
Mailing Address - Country:US
Mailing Address - Phone:937-527-6239
Mailing Address - Fax:
Practice Address - Street 1:8087 CINCINNATI DAYTON RD STE A
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2003
Practice Address - Country:US
Practice Address - Phone:937-527-6239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily