Organization · NPI-2

Aesthetic Concepts LLC

Nurse Practitioner, Family · Idaho Falls, ID

NPI number1871734293

StatusActive

Last updated in NPPESMar 13, 2009

Details

NPI: 1871734293
Entity type: Organization (NPI-2)
Legal business name: Aesthetic Concepts LLC
Organization subpart: No
Enumeration date: Mar 13, 2009
Last updated: Mar 13, 2009

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LF0000X	Nurse Practitioner, Family	NP 669-A	ID	Yes

Practice location

2860 Channing Way Ste 224
Idaho Falls, ID 83404-7541

Phone 208-529-6430 · Fax 208-529-6428

Mailing address

2860 Channing Way Ste 224
Idaho Falls, ID 83404-7541

Phone 208-529-6430 · Fax 208-529-6428

Authorized official

Lisa June Zajanc
Owner Nurse Practitioner
2085296430

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.