MEDICARE: BEYOND BEAUTY PRIMARY CARE & WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1881526952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEYOND BEAUTY PRIMARY CARE & WELLNESS

Provider Business Mailing Address
First Line	:	11704 WASHINGTON GREEN RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40229-5533
Country	:	US
Telephone Number	:	502-544-4047
Fax Number	:	502-544-4047

Provider Business Practice Location Address
First Line	:	11704 WASHINGTON GREEN RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40229-5533
Country	:	US
Telephone Number	:	502-544-4047
Fax Number	:	502-544-4047

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	STACY MCBRIDE
Credential	:	NP
Telephone Number	:	502-544-4047

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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