Healthcare Provider Details

I. General information

NPI: 1669394722
Provider Name (Legal Business Name): BEAUTIFUL WOUNDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43288 W ANNE LN
MARICOPA AZ
85138-1542
US

IV. Provider business mailing address

43288 W ANNE LN
MARICOPA AZ
85138-1542
US

V. Phone/Fax

Practice location:
  • Phone: 623-428-1145
  • Fax:
Mailing address:
  • Phone: 623-428-1145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: DUREL WILLIAMS
Title or Position: FOUNDER/PRESIDENT
Credential:
Phone: 623-428-1145