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General NPI Number Information
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NPI Number | 1225858772
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Entity Type | Organization
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Legal Business Name | KAESTHETICS
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Dates
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Enumeration Date | 10/10/2024
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 29509 CANVASBACK DR STE 207
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City | EASTON
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State | MD
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Zip | 21601-7164
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Country | US
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Telephone | 410-829-2543
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Fax | 620-647-4530
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Provider Business Mailing Address
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Address Line | 8661 BRENTON DR
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City | EASTON
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State | MD
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Zip | 21601-1216
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Country | US
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Telephone | 410-829-2543
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Fax | 620-647-4530
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Authorized Official
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Title or Position | CRNP
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Name | KRYSTAL ALGIER
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Credential | NURSE PRACTITIONER
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Telephone | 410-829-2543
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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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