MEDICARE: AGELESS SKIN REJUVENATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1164133716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGELESS SKIN REJUVENATION LLC

Provider Business Mailing Address
First Line	:	3352 PRINCESS ANNE RD STE 909
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-2608
Country	:	US
Telephone Number	:	757-707-1231
Fax Number	:

Provider Business Practice Location Address
First Line	:	3352 PRINCESS ANNE RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-2608
Country	:	US
Telephone Number	:	757-707-1231
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RACHEL ANNE KING
Credential	:	NP
Telephone Number	:	757-707-1231

Provider Enumeration Date	:	12/05/2022
Last Update Date	:	12/05/2022

Similar Medicare Providers

1902950686 — MRS. SHARON MCCASKILL RN
Practice Location Address:

2608 PINEY BARK DR
VIRGINIA BEACH, VA
23456-3926

Practice Phone: 757-427-9491
Practice Fax:

1770877631 — MS. RACHEL ANNE KING C-NP
Practice Location Address:

3352 PRINCESS ANNE RD STE 909
VIRGINIA BEACH, VA
23456-2608

Practice Phone: 757-707-1231
Practice Fax: 757-707-1232

1043650476 — MRS. MARSHA C MAYO LCSW
Practice Location Address:

2608 PENDER DR
VIRGINIA BEACH, VA
23456-3561

Practice Phone: 757-646-2301
Practice Fax:

1114380359 — SEAN C MABEY MD
Practice Location Address:

2608 NESTLEBROOK TRL
VIRGINIA BEACH, VA
23456-8201

Practice Phone: 414-795-3692
Practice Fax:

1669116828 — MONIQUE WHITEHURST FNP
Practice Location Address:

3352 PRINCESS ANNE RD UNIT S-909
VIRGINIA BEACH, VA
23456-2608

Practice Phone: 757-707-1231
Practice Fax:

1760160808 — STEPHANIE GRAFTON APRN
Practice Location Address:

3352 PRINCESS ANNE RD STE 909
VIRGINIA BEACH, VA
23456-2608

Practice Phone: 757-707-1231
Practice Fax: 757-707-1232

Directions to “AGELESS SKIN REJUVENATION LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.