Provider Demographics
NPI:1235886870
Name:ABOVE & BEYOND WELLNESS AND MEDSPA, PLLC
Entity type:Organization
Organization Name:ABOVE & BEYOND WELLNESS AND MEDSPA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SESSOMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-991-3060
Mailing Address - Street 1:505 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:28337-9471
Mailing Address - Country:US
Mailing Address - Phone:910-991-3060
Mailing Address - Fax:910-226-7566
Practice Address - Street 1:505 W BROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337-9471
Practice Address - Country:US
Practice Address - Phone:910-991-3060
Practice Address - Fax:910-226-7566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-03
Last Update Date:2024-10-07
Deactivation Date:2024-06-10
Deactivation Code:
Reactivation Date:2024-06-28
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty