# BLUSH MEDICAL AESTHETICS & WELLNESS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871382051
- **Authorized official:** MISTY ANN BURTON FNP (OWNER/OPERATOR)
- **Authorized official phone:** (662) 515-0016

## Contact information

- **Practice address:** 940 CHURCH RD W STE B, SOUTHAVEN, MS 38671-9611
- **Practice address phone:** (662) 515-0016
- **Mailing address:** 940 CHURCH RD W STE B, SOUTHAVEN, MS 38671-9611
- **Mailing address phone:** (662) 515-0016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QI0500X | Infusion Therapy Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/05/2025
- **Last updated:** 05/05/2025