Provider Demographics
NPI:1992507875
Name:DR MOMS HEALTH AND BEAUTY LLC
Entity type:Organization
Organization Name:DR MOMS HEALTH AND BEAUTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, FNP
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MSN, FNP-BC
Authorized Official - Phone:480-955-9636
Mailing Address - Street 1:6264 S TWILIGHT CT
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85298-8845
Mailing Address - Country:US
Mailing Address - Phone:801-854-8244
Mailing Address - Fax:480-604-2634
Practice Address - Street 1:2034 E SOUTHERN AVE STE X
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7519
Practice Address - Country:US
Practice Address - Phone:801-854-8244
Practice Address - Fax:480-604-2634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-24
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty