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General NPI Number Information
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NPI Number | 1932971801
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Entity Type | Organization
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Legal Business Name | FLUID AESTHETICS & WELLNESS
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Dates
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Enumeration Date | 10/24/2023
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 7370 HODGSON MEMORIAL DRIVE SUITE E12
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City | SAVANNAH
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State | GA
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Zip | 31406
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Country | US
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Telephone | 912-268-0002
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Fax | 888-494-4209
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Provider Business Mailing Address
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Address Line | 5710 OGEECHEE ROAD SUITE 200 BOX 310
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City | SAVANNAH
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State | GA
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Zip | 31405
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Country | US
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Telephone | 912-268-0002
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Fax | 888-494-4209
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Authorized Official
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Title or Position | CREDENTIALING SPECIALISTS
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Name | KIMBERLY DAVIS
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Credential |
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Telephone | 912-373-4385
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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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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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