Provider Demographics
NPI:1831062736
Name:THRIVEWELL HEALTH CLINIC, LLC
Entity type:Organization
Organization Name:THRIVEWELL HEALTH CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CONRAD
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:308-763-1354
Mailing Address - Street 1:297 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROADWATER
Mailing Address - State:NE
Mailing Address - Zip Code:69125-9741
Mailing Address - Country:US
Mailing Address - Phone:308-672-7129
Mailing Address - Fax:
Practice Address - Street 1:1821 1ST AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-2449
Practice Address - Country:US
Practice Address - Phone:308-672-7129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty