SECRET GURU PERMANENT MAKEUP; NPI #1033825062

Contact Information

SECRET GURU PERMANENT MAKEUP

587 SOUTHLAKE BLVD STE A
NORTH CHESTERFIELD, VA 23236-3096

Phone: 804-895-7616
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Medical Art Specialist/Technologist	246ZA2600X

Indicates primary specialty

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NPI Profile & details for SECRET GURU PERMANENT MAKEUP

NPI #	`1033825062`
LBN Legal business name	SECRET GURU PERMANENT MAKEUP
Authorized official	CHRISTINA SOUTHERS - (OWNER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	01/24/2023
Last updated	01/24/2023 - About 3 years ago
Identifiers	n/a

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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SECRET GURU PERMANENT MAKEUP

Contact Information

Specialty

Medical Art Specialist/Technologist

NPI Profile & details for SECRET GURU PERMANENT MAKEUP

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