Bella Rose Skin Care PLLC
Organization Active NPI Health Service Clinic/Center · Alpena, MI
NPI 1669004875 · NPPES record last updated Mar 24, 2020
Key facts
- NPI
- 1669004875
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Service Clinic/Center 261QH0100X
- Legal business name
- BELLA ROSE SKIN CARE PLLC
- Practice address
- 114 E Oldfield St
Alpena, MI 49707-2354 - Phone
- (989) 464-1883
- NPI assigned
- Feb 5, 2020
- Organization subpart
- No
Authorized official
- Name
- Jessica Glenn-Beatty
- Title
- Owner
- Phone
- (989) 464-1883
Practitioners 1
-
Jessica Bruning, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200520002848 | MI | Part B Supplier - Clinic/Group Practice | 1850722190 |
Receives reassigned benefits from 1 practitioner Practice locations: Alpena, MI |
National Provider Directory
Locations
104 N Second Ave
Alpena, MI 49707
Phone (989) 464-1883
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | Yes |
Addresses
Primary practice location
114 E Oldfield St
Alpena, MI 49707-2354
Mailing address
114 E Oldfield St
Alpena, MI 49707-2354
Other names
- Bella Rose Skin Care and Wellness Center
Other providers in Alpena, MI
- Wael Mohamad Baydoun
- David M Beatty
- Jason L Beatty
- Santiago Jose Becerra
- Jack Hunter Behl
- Jordan Bellmore
- Josephine Bellmore
- Kiel Thomas Beltinck
- Bonnie Benac
- Julie Anne Benson
All providers in Alpena, MI · Health Service Clinic/Center in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.