Provider Demographics
NPI:1184384950
Name:THE SKIN REFINERY LLP
Entity type:Organization
Organization Name:THE SKIN REFINERY LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:NEFF
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:812-490-0301
Mailing Address - Street 1:7500 LAUREN DRIVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725
Mailing Address - Country:US
Mailing Address - Phone:812-629-1800
Mailing Address - Fax:812-398-7473
Practice Address - Street 1:707 STATE ST STE 3C
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-1185
Practice Address - Country:US
Practice Address - Phone:812-629-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0173717586OtherFEDERAL ID