NPIMap

Organization Active NPI

Nucanvas Aesthetics and Wellness Center PLLC

  • Nurse Practitioner
  • Henderson, NV
National Provider Identifier
1467192138
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
NUCANVAS AESTHETICS AND WELLNESS CENTER PLLC
Practice address
871 Coronado Center Dr Ste 200
Henderson, NV 89052-3977
Phone
(702) 308-6923
NPI assigned
Mar 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Mailo K Brantner, NPNPI 1558739110
Title
Ceo
Phone
(702) 308-6923

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

871 Coronado Center Dr Ste 200
Henderson, NV 89052-3977

Mailing address

871 Coronado Center Dr Ste 200
Henderson, NV 89052-3977
Phone (702) 308-6923

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1467192138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 CORONADO CENTER DR STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523977",
            "telephone_number": "702-308-6923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 CORONADO CENTER DR STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523977",
            "telephone_number": "702-308-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUCANVAS AESTHETICS AND WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "BRANTNER",
        "authorized_official_first_name": "MAILO",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "702-308-6923",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.