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The Team

Who We Are


Tiffany Bracamonte

Founder & Nurse Practitioner

417 Refine was established in 2020 by Tiffany Bracamonte, MSN, FNP-C. 

Tiffany had 10+ years in Emergency Medicine under her belt when she found her passion for the aesthetic industry. Since then, she has added injectors, mentorships, established multiple locations, and added a range of services to her offerings.

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Jennifer Creach

RN, Nurse Injector

 Outside of work, one of my biggest passions in life has been my journey with skincare. Understanding the clinical research, findings and insights is key to getting the best results. Not only am I passionate about skin and beauty, but I have a genuine desire to instill confidence and provide a sense of empowerment through a specialized art form. As your Aesthetic Nurse Injector I can’t wait to get to know you, your needs, and how we can achieve your ideal results together!

(Previous nursing experience: Labor & Delivery)

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Naomi Sweet

RN, Nurse Injector

My passion has always been aesthetic medicine. While I firmly believe that no one needs neurotoxins or fillers to be beautiful or to feel great, it can definitely enhance and highlight what you’ve already got goin’ on. My goal is to end this idea of tox & fillers being vain and high maintenance.

I hope people learn to accept it as another form of self-care and self-love! I can't wait to start this journey with you!

(Previous nursing experience: Emergency Room)

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Shelby Lotz

RN, Nurse Injector

I've always been passionate about skincare. I love helping people feel more confident in their own skin, not only with the treatments we do, but just hyping people up and helping them learn to believe in themselves. I always wanted to get into this industry and the universe brought us together at just the right time!

(Previous nursing experience: 2 years long term care, then neuro trauma stepdown)


Servicing Joplin, Missouri

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