Provider Demographics
NPI:1518756550
Name:PRIME AESTHETICS AND WELLNESS, PLLC
Entity type:Organization
Organization Name:PRIME AESTHETICS AND WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C
Authorized Official - Phone:214-551-2680
Mailing Address - Street 1:604 STATE HIGHWAY 78 N STE 103
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75442-1032
Mailing Address - Country:US
Mailing Address - Phone:972-782-5043
Mailing Address - Fax:972-435-4374
Practice Address - Street 1:301 E AUDIE MURPHY PKWY STE B
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75442-2713
Practice Address - Country:US
Practice Address - Phone:972-782-5043
Practice Address - Fax:972-435-4374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care