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General NPI Number Information
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NPI Number | 1669343356
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Entity Type | Organization
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Legal Business Name | RESURRECTION MEDICAL AESTHETICS, LLC
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 216 FOURTH AVE STE 1
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City | SEWARD
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State | AK
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Zip | 99664-4210
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Country | US
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Telephone | 770-596-9050
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Fax | 855-975-3125
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Provider Business Mailing Address
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Address Line | PO BOX 715
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City | SEWARD
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State | AK
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Zip | 99664-0715
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Country | US
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Telephone | 770-596-9050
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Fax | 855-975-3125
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Authorized Official
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Title or Position | OWNER
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Name | JULIE CRITES
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Credential | NP
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Telephone | 770-596-9050
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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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