Nuderma Med Spa and Wellness Center

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

NUDERMA MED SPA AND WELLNESS CENTER

Practice address

N14W23777 Stone Ridge Dr Ste 290
Waukesha, WI 53188-1140

Phone

(262) 716-7580

NPI assigned

Jan 13, 2023

Last updated

Jan 13, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Justin Hanson

Title

President

Phone

(262) 716-7580

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1215642285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N14W23777 STONE RIDGE DR STE 290",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N14W23777 STONE RIDGE DR STE 290",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881140",
            "telephone_number": "262-716-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUDERMA MED SPA AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-716-7580"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Stephen Novak, D.D.S.
• Sarah A Nowak, P.A.
• Zoe Nowell
• Jennifer A Nowicki, RN
• Alison Noyes
• Holly Numan, LPC, SAC-IT
• NX Level Physical Therapy LLC (Fyzical Therapy and Balance Waukesha)
• Elizabeth Ann Nygren, R.N.
• Maria Melissa O'Brien, M.S.
• Michael P O'Brien, M.D.

• Health Service Clinic/Center in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Health Service Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.