SKINLAB 360 DERMATOLOGY & AESTHETICS LLC
NPI 1376125740
Physician Assistant in Rexburg, ID

Q: What is Skinlab 360 Dermatology & Aesthetics LLC's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since April 26, 2021

117 W MAIN ST STE 101, REXBURG, ID 83440(208) 709-0478 Get Directions Write a Review

NPPES record last updated: April 26, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Skinlab 360 Dermatology & Aesthetics Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SKINLAB 360 DERMATOLOGY & AESTHETICS LLC (NPI 1376125740) is a healthcare organization registered as a physician assistant in Rexburg, Idaho and active in the NPI registry since April 2021. The organization lists Julie Anderson, Owner, as its authorized official.

NPPES Registry Identity

NPI1376125740

Entity TypeOrganization

Primary Taxonomy363A00000X

Legal Business NameSKINLAB 360 DERMATOLOGY & AESTHETICS LLC

Location Address117 W MAIN ST STE 101Rexburg, ID 83440-1826

Mailing AddressPo Box 3625Idaho Falls, ID 83403-3625 · (800) 338-5378 · Fax (208) 523-8978

Phone(208) 709-0478

Organization SubpartNo

Authorized OfficialJulie AndersonOwner · (208) 709-0478

Enumeration DateApril 26, 2021

NPPES CertifiedApril 26, 2021

✔ NPI 1376125740 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

117 W MAIN ST STE 101, Rexburg, ID 83440

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIE MARIE ANDERSON P.A.

Physician Assistant

117 W MAIN ST STE 101
REXBURG, ID 83440

Madison County (208) 709-0478

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Skinlab 360 Dermatology & Aesthetics LLC's NPI number?

The NPI number for Skinlab 360 Dermatology & Aesthetics LLC is 1376125740. It was assigned to this organization in the NPPES registry on April 26, 2021.

Where is Skinlab 360 Dermatology & Aesthetics LLC located?

Skinlab 360 Dermatology & Aesthetics LLC is located at 117 W Main St Ste 101, Rexburg, ID 83440. The listed phone number is (208) 709-0478.

What is Skinlab 360 Dermatology & Aesthetics LLC's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Skinlab 360 Dermatology & Aesthetics LLC was last updated on April 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.