Provider Demographics
NPI:1386366649
Name:FIRST STEPS WELLNESS LLC
Entity type:Organization
Organization Name:FIRST STEPS WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:CHEREE
Authorized Official - Last Name:BUCKNER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:270-306-1008
Mailing Address - Street 1:252 N MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42276-1825
Mailing Address - Country:US
Mailing Address - Phone:270-216-0864
Mailing Address - Fax:
Practice Address - Street 1:252 N MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:KY
Practice Address - Zip Code:42276-1825
Practice Address - Country:US
Practice Address - Phone:270-216-0864
Practice Address - Fax:270-596-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-14
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty