Provider Demographics
NPI:1710396296
Name:INSPIRED BY U, LLC
Entity Type:Organization
Organization Name:INSPIRED BY U, LLC
Other - Org Name:INSPIRED BY U, HAIR LOSS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DENEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED HAIR LOSS
Authorized Official - Phone:910-345-7574
Mailing Address - Street 1:155 BONANZA DR STE 101B
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-2767
Mailing Address - Country:US
Mailing Address - Phone:910-487-0001
Mailing Address - Fax:
Practice Address - Street 1:155 BONANZA DR. STE 101B
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303
Practice Address - Country:US
Practice Address - Phone:910-354-7574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENEKA MCMILLAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC241534826OtherCERTIFIED HAIR LOSS SPECIALIST