Provider Demographics
NPI:1871341149
Name:BEAUTY EMBRACE MEDSPA, PLLC
Entity type:Organization
Organization Name:BEAUTY EMBRACE MEDSPA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NP
Authorized Official - Prefix:
Authorized Official - First Name:JANIETA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:630-930-2975
Mailing Address - Street 1:1220 TIMBER DR E
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-6917
Mailing Address - Country:US
Mailing Address - Phone:984-960-9654
Mailing Address - Fax:
Practice Address - Street 1:8801 FAST PARK DRIVE SUITE 301
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617
Practice Address - Country:US
Practice Address - Phone:984-960-9654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service