Beautifully Scarred,LLC

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

ESTE-170641 Issued in OH

Legal business name

BEAUTIFULLY SCARRED,LLC

Practice address

6924 Spring Valley Dr Ste 160
Holland, OH 43528-9482

Phone

(419) 322-0567

NPI assigned

Aug 6, 2017

Organization subpart

No

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

Authorized official

Name

Qiana Depp, ESTHETICIAN

Title

Managing Esthetician

Phone

(419) 322-0567

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1501977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501977600000",
    "number": "1871018325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6924 SPRING VALLEY DR STE 160",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435289482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6924 SPRING VALLEY DR STE 160",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435289482",
            "telephone_number": "419-322-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUTIFULLY SCARRED,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-06",
        "last_updated": "2017-08-06",
        "status": "A",
        "authorized_official_last_name": "DEPP",
        "authorized_official_first_name": "QIANA",
        "authorized_official_title_or_position": "MANAGING ESTHETICIAN",
        "authorized_official_telephone_number": "419-322-0567",
        "authorized_official_credential": "ESTHETICIAN"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "OH",
            "license": "ESTE-170641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey L Barley, DDS
• Alecia Barrett
• Min-Dee Bartel, MSN, APRN, PMHNP-BC
• Kelsey Ann Bartolet
• Taylor Bates
• Mark William Becker, DDS
• Ariana Jean Behm, CDCAP
• Amanda Marie Bell, CDCA
• Shawnia Marie Bennett, R.N.
• Christina M Benson, OTR/L OTD

• Procedural Dermatology Physician in Holland, OH
• Providers in Holland, OH by specialty
• Procedural Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.