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General NPI Number Information
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NPI Number | 1801522990
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Entity Type | Organization
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Legal Business Name | THIRTY-THREE MEDSPA
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Dates
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Enumeration Date | 07/29/2022
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Last Update Date | 07/29/2022
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Provider Practice Location Address
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Address Line | 725 HIGHWAY 145 S
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City | BALDWYN
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State | MS
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Zip | 38824-8913
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Country | US
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Telephone | 662-416-2737
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Fax |
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Provider Business Mailing Address
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Address Line | 208 WESTOVER HTS
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City | BOONEVILLE
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State | MS
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Zip | 38829-1106
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Country | US
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Telephone | 166-241-6273
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Fax |
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Authorized Official
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Title or Position | FNP/OWNER
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Name | MRS. LAUREN K HORTON
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Credential | FNP
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Telephone | 662-416-2737
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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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