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General NPI Number Information
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NPI Number | 1699369926
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Entity Type | Organization
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Legal Business Name | BEAUTIFULLY AT HOME LLC
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Dates
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Enumeration Date | 02/26/2021
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 13866 SYMINGTON PKWY NW
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City | BREMERTON
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State | WA
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Zip | 98312-9657
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Country | US
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Telephone | 360-471-9368
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Fax |
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Provider Business Mailing Address
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Address Line | 13866 SYMINGTON PKWY NW
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City | BREMERTON
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State | WA
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Zip | 98312-9657
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Country | US
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Telephone | 360-471-9368
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Fax |
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | MS. SANDRA LOUISE WALKER
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Credential | APRN
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Telephone | 360-471-9368
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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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