Healthcare Provider Details

I. General information

NPI: 1578344693
Provider Name (Legal Business Name): JEANETTE WIRZ PERMANENT COSMETICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2023
Last Update Date: 10/13/2023
Certification Date: 09/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8327 SAWYER BROWN RD
NASHVILLE TN
37221-2539
US

IV. Provider business mailing address

8327 SAWYER BROWN RD
NASHVILLE TN
37221-2539
US

V. Phone/Fax

Practice location:
  • Phone: 615-400-2780
  • Fax:
Mailing address:
  • Phone: 615-400-2780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MS. JEANETTE WIRZ
Title or Position: OWNER
Credential:
Phone: 615-400-2780