Organization
BLUSH MEDICAL AESTHETICS & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY ANN BURTON FNP (OWNER/OPERATOR)
(662) 515-0016
Entity
Organization
Contact information
Practice address
940 CHURCH RD W STE B, SOUTHAVEN, MS 38671-9611
(662) 515-0016
Mailing address
940 CHURCH RD W STE B, SOUTHAVEN, MS 38671-9611
(662) 515-0016
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
05/05/2025
Last updated
05/05/2025
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