Beautiful You Dermatology LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

BEAUTIFUL YOU DERMATOLOGY LLC

Practice address

310 Lake St S
Big Lake, MN 55309-4616

Phone

(319) 215-5752

NPI assigned

Feb 28, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Crista Beth Wenisch, DCNPNPI 1235401464

Title

Nurse Practitioner

Phone

(319) 215-5752

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Crista B Wenisch, A.R.N.P.

  • Family Nurse Practitioner
  • Burnsville, MN
  • NPI 1235401464

  Family, MN

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1033818976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 LAKE ST S",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553094616",
            "telephone_number": "319-215-5752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 LAKE ST S",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553094616",
            "telephone_number": "319-215-5752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUTIFUL YOU DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-28",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "WENISCH",
        "authorized_official_first_name": "CRISTA",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "319-215-5752",
        "authorized_official_credential": "DCNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronda M. Adelmann, MA
• Kamal Ahmed, DDS
• Nabeel Bishara Ailabouni, DO
• Trent Leigh Anderson, R.PH.
• Apple Ride LLC
• Neeharika Bhashyam
• Big Lake Dental, PA
• Shanyce Bishop, LGSW
• Teresa Newstrom Bondhus, RN
• Kyle Braulick

• All providers in Big Lake, MN
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.