Provider Demographics
NPI:1235886870
Name:ABOVE & BEYOND WELLNESS AND MEDSPA, PLLC
Entity Type:Organization
Organization Name:ABOVE & BEYOND WELLNESS AND MEDSPA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-991-3060
Mailing Address - Street 1:505 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:28337-9471
Mailing Address - Country:US
Mailing Address - Phone:910-991-3060
Mailing Address - Fax:
Practice Address - Street 1:505 W BROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337-9471
Practice Address - Country:US
Practice Address - Phone:910-991-3060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-03
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty