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General NPI Number Information
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NPI Number | 1477379436
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Entity Type | Organization
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Legal Business Name | KESANI ESSENTIALS WELLNESS AND AESTHETICS MEDSPA PLLC
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 6911 RICHMOND HWY STE 301A
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City | ALEXANDRIA
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State | VA
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Zip | 22306-1846
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Country | US
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Telephone | 703-215-7957
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Fax |
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Provider Business Mailing Address
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Address Line | 6911 RICHMOND HWY STE 301A
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City | ALEXANDRIA
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State | VA
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Zip | 22306-1846
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Country | US
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Telephone | 703-215-7957
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Fax |
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Authorized Official
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Title or Position | CEO/NP
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Name | MS. NICOLE DEASE
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Credential | NP
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Telephone | 571-572-2303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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