Healthcare Provider Details

I. General information

NPI: 1629944111
Provider Name (Legal Business Name): BEAUTY IN VEIN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3531 MACKINAC ISLAND LN
RALEIGH NC
27610-6432
US

IV. Provider business mailing address

3531 MACKINAC ISLAND LN
RALEIGH NC
27610-6432
US

V. Phone/Fax

Practice location:
  • Phone: 804-774-9985
  • Fax:
Mailing address:
  • Phone: 804-774-9985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LUCRETIA ANN BELL
Title or Position: CEO
Credential:
Phone: 804-774-9985