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General NPI Number Information
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NPI Number | 1205621844
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Entity Type | Organization
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Legal Business Name | ILLUMINA AESTHETICS LLC
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 413 BLISS DR
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City | PITTSBURGH
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State | PA
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Zip | 15236-4008
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Country | US
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Telephone | 412-805-5054
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Fax |
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Provider Business Mailing Address
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Address Line | 413 BLISS DR
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City | PITTSBURGH
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State | PA
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Zip | 15236-4008
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Country | US
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Telephone | 412-805-5054
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMBER NJOYA
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Credential | CRNP
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Telephone | 412-805-5054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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