Provider Demographics
NPI:1174185011
Name:A NEW YOU PERMANENT MAKEUP LLC
Entity Type:Organization
Organization Name:A NEW YOU PERMANENT MAKEUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD ARTIST/CEO
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-444-7397
Mailing Address - Street 1:1007 STINE RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-4142
Mailing Address - Country:US
Mailing Address - Phone:661-444-7397
Mailing Address - Fax:
Practice Address - Street 1:1007 STINE RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-4142
Practice Address - Country:US
Practice Address - Phone:661-444-7397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service