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NPI Code Detail

MEDICARE: ADVANCED AESTHETICS AND WELLNESS

MEDICARE: ADVANCED AESTHETICS AND WELLNESS
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
1261QP2300XPrimary Care Clinic/Center

General Provider Information

NPI Number : 1902591134
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED AESTHETICS AND WELLNESS
Provider Business Mailing Address
First Line : 3150 S 6TH ST
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97603-4612
Country : US
Telephone Number : 541-851-9008
Fax Number : 541-851-9114
Provider Business Practice Location Address
First Line : 3150 S 6TH ST
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97603-4612
Country : US
Telephone Number : 541-851-9008
Fax Number : 541-851-9114
Authorized Official
Title or Position : OWNER/NURSE PRACTITIONER
Name : KIRSTEN BALIN
Credential : NP
Telephone Number : 541-851-9008
Provider Enumeration Date : 04/05/2023
Last Update Date : 12/03/2025

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Directions to “ADVANCED AESTHETICS AND WELLNESS ” 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.