1134939721 NPI number — SOINS ESTHETIQUES, LLC

Table of content: (NPI 1134939721)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134939721 NPI number — SOINS ESTHETIQUES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOINS ESTHETIQUES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134939721
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
123 ALAMOSA RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORMAN
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73069-3126
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-301-5802
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2457 WILCOX DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORMAN
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73069-3956
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-497-7395
Provider Business Practice Location Address Fax Number:
810-202-7375
Provider Enumeration Date:
01/07/2025

Additional Information

Authorized Official

Authorized Official Last Name:
COLLETT
Authorized Official First Name:
JESSICA
Authorized Official Middle Name:
Authorized Official Title or Position:
NURSE PRACTITIONER
Authorized Official Telephone Number:
405-301-5802

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com