Provider Demographics
NPI:1417755638
Name:UPLIFT WELLNESS AND AESTHETICS PLLC
Entity type:Organization
Organization Name:UPLIFT WELLNESS AND AESTHETICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HAYLER
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:832-264-3676
Mailing Address - Street 1:15 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEAGLE
Mailing Address - State:TN
Mailing Address - Zip Code:37356-3074
Mailing Address - Country:US
Mailing Address - Phone:832-264-3676
Mailing Address - Fax:
Practice Address - Street 1:15 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MONTEAGLE
Practice Address - State:TN
Practice Address - Zip Code:37356-3074
Practice Address - Country:US
Practice Address - Phone:832-264-3676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty