Provider Demographics
NPI:1225613946
Name:MEDICAL SPA NP LLC
Entity Type:Organization
Organization Name:MEDICAL SPA NP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:N
Authorized Official - Last Name:ECKLES HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-774-2897
Mailing Address - Street 1:2686 N COLUMBUS ST STE 202
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-8404
Mailing Address - Country:US
Mailing Address - Phone:614-774-2897
Mailing Address - Fax:
Practice Address - Street 1:2686 N COLUMBUS ST STE 202
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8404
Practice Address - Country:US
Practice Address - Phone:614-774-2897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty