Organization
A PRESTIGE AESTHETIC AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMOTAYO ANDREA PRYOR CRNP (CRNP)
(256) 348-2107
Entity
Organization
Contact information
Practice address
374 SPENCER LAKES DR, MERIDIANVILLE, AL 35759-1532
(256) 427-4739
Mailing address
504 AUTUMN SPRINGS CT STE 19, FRANKLIN, TN 37067-2849
(256) 348-2107
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
08/23/2020
Last updated
12/30/2023
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