Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lifestyle Wellness LLC

Organization Nurse Practitioner · NPI 1750016192

Lifestyle Wellness LLC is a Nurse Practitioner in Prescott Valley, Arizona. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3192 N Windsong Dr
Prescott Valley, AZ 86314-2239
Phone: (928) 288-0500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1750016192
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Colleen Petullo — Nurse Practitioner · (928) 288-0500
Other names Lifestyle Wellness Llc
NPI enumeratedJuly 20, 2022
Last updated in NPPESAugust 22, 2022
Certification dateAugust 22, 2022
Mailing address3192 N Windsong Dr, Prescott Valley, AZ 86314-2239

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