Organization
JVM COSMETIC AND WELLNESS SPA LLC
Active
Other names
JVM Cosmetic and Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEGAN KATHLEEN HACKER NP (NURSE PRACTITIONER)
(513) 833-1619
Entity
Organization
Contact information
Practice address
1501 ALEXANDRIA PIKE STE 114, FORT THOMAS, KY 41075-2561
(513) 833-1619
Mailing address
1501 ALEXANDRIA PIKE STE 114, FORT THOMAS, KY 41075-2561
(513) 833-1619
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659733244
INDIVIDUAL NPI
—
05
—
7100402060
—
KY
Enumeration date
06/07/2021
Last updated
10/01/2021
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