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General NPI Number Information
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NPI Number | 1245149525
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Entity Type | Organization
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Legal Business Name | TIMELESS SKIN STUDIO, LLC
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 123 W WATER ST
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City | HODGENVILLE
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State | KY
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Zip | 42748-1535
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Country | US
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Telephone | 270-358-8725
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Fax | 270-203-8610
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Provider Business Mailing Address
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Address Line | 123 W WATER ST
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City | HODGENVILLE
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State | KY
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Zip | 42748-1535
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Country | US
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Telephone | 270-358-8725
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Fax | 270-203-8610
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Authorized Official
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Title or Position | APRN/ CO-OWNER
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Name | TANYA WILLIAMS
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Credential | APRN
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Telephone | 270-268-8968
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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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