Provider Demographics
NPI:1598383572
Name:ENHANCE THE AESTHETIC & WELLNESS CO.
Entity Type:Organization
Organization Name:ENHANCE THE AESTHETIC & WELLNESS CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLERY
Authorized Official - Middle Name:HANCOCK
Authorized Official - Last Name:NAGHTIN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:270-484-0872
Mailing Address - Street 1:801 COUNTRY CLUB LN
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-1370
Mailing Address - Country:US
Mailing Address - Phone:270-484-0872
Mailing Address - Fax:
Practice Address - Street 1:801 COUNTRY CLUB LN
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1370
Practice Address - Country:US
Practice Address - Phone:270-484-0872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care