# BEYOUTIFUL WELLNESS CLINIC & RAPID LABS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BEYOUTIFUL WELLNESS CLINIC & RAPID LABS LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184480618
- **Authorized official:** TANYA RIDEOUT (CEO)
- **Authorized official phone:** (601) 441-2481

## Contact information

- **Practice address:** 4900 OLD HIGHWAY 11 STE 4, HATTIESBURG, MS 39402-8656
- **Practice address phone:** (601) 441-9846
- **Mailing address:** 1661 DAWSEY DR, COLUMBIA, MS 39429-7736
- **Mailing address phone:** (601) 441-2481

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 171400000X | Health & Wellness Coach | — | NULL | Yes |
| 171400000X | Health & Wellness Coach | — | — | Yes |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | — | NULL | — |
| 207NI0002X | Clinical & Laboratory Dermatological Immunology Physician | — | — | — |
| 246RM2200X | Medical Laboratory Technician | — | NULL | — |
| 246RM2200X | Medical Laboratory Technician | — | — | — |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |

## Other

- **Enumeration date:** 02/22/2024
- **Last updated:** 02/22/2024