Provider Demographics
NPI:1114721719
Name:ALLURING AESTHETICS PLLC
Entity type:Organization
Organization Name:ALLURING AESTHETICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:REIS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:904-540-1391
Mailing Address - Street 1:12760 QUARTERHORSE LN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5046
Mailing Address - Country:US
Mailing Address - Phone:904-540-1391
Mailing Address - Fax:
Practice Address - Street 1:300 ELLICOTT ST STE D
Practice Address - Street 2:
Practice Address - City:OCCOQUAN
Practice Address - State:VA
Practice Address - Zip Code:22125-7715
Practice Address - Country:US
Practice Address - Phone:904-540-1391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center