LAKESIDE AESTHETICS - LLC; NPI #1851873756

Contact Information

LAKESIDE AESTHETICS - LLC

1005 HIGHWAY 2
SANDPOINT, ID 83864-1702

Phone: 208-290-3302
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Primary Care	363LP2300X	50	Nurse Practitioner
Family	363LF0000X	50	Nurse Practitioner
Family Medicine	207Q00000X	08	Physician/Family Practice
Nurse Practitioner	363L00000X	50	Nurse Practitioner

Indicates primary specialty

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NPI Profile & details for LAKESIDE AESTHETICS - LLC

NPI Number 1851873756

LBN Legal business name LAKESIDE AESTHETICS - LLC

Authorized official KELLY FUHRMAN - (OWNER/NP)

Entity Organization

Organization subpart ¹ No

Enumeration date 09/06/2018

Last updated 03/06/2019 - About 7 years ago

Identifiers

ID	License #	NP1029A
ID	Other	NP1029A	IDAHO STATE LICENSE NUMBER

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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LAKESIDE AESTHETICS - LLC

Contact Information

Specialty

Primary Care

Family

Family Medicine

Nurse Practitioner

NPI Profile & details for LAKESIDE AESTHETICS - LLC

Reviews for LAKESIDE AESTHETICS - LLC