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General NPI Number Information
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NPI Number | 1740150507
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Entity Type | Organization
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Legal Business Name | SKIN INVY HYDRATION AND WELLNESS PLLC
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 10130 MALLARD CREEK RD STE 310
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City | CHARLOTTE
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State | NC
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Zip | 28262-6001
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Country | US
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Telephone | 980-406-0185
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Fax |
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Provider Business Mailing Address
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Address Line | 10421 KEMPSFORD DR
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City | CHARLOTTE
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State | NC
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Zip | 28262-2718
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Country | US
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Telephone | 980-433-0517
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MRS. VANESSA MARIE MADDEN-GILYARD
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Credential | NP
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Telephone | 980-433-0517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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