AURORA AESTHETICS AND FUNCTIONAL MEDICINE CLINIC PLLC NPI 1184231979

NPI Information

NPI: 1184231979
Provider Name: AURORA AESTHETICS AND FUNCTIONAL MEDICINE CLINIC, PLLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 16D2213350

Address:
713 1ST AVE NW
MOUNT VERNON, IA
ZIP 52314
Phone: (907) 350-7228
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AURORA AESTHETICS AND FUNCTIONAL MEDICINE CLINIC, PLLC is a primary care clinic center in Mount Vernon, IA. AURORA AESTHETICS AND FUNCTIONAL MEDICINE CLINIC, PLLC NPI is 1184231979. The provider is registered as an organization entity type.

The provider's business location address is:

713 1ST AVE NW
MOUNT VERNON, IA
ZIP 52314-478
Phone: (907) 350-7228

The provider's authorized official is Stephanie M Friess .
The authorized official title is Partner and has the following contact phone number (907) 350-7228.

The CLIA number assigned to this NPI record is 16D2213350 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/25/2020 and was last updated on 9/25/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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