Healthcare Provider Details

I. General information

NPI: 1306709985
Provider Name (Legal Business Name): HER AESTHETICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W REINKEN AVE
BELEN NM
87002-4241
US

IV. Provider business mailing address

1100 N MESA RD
BELEN NM
87002-8567
US

V. Phone/Fax

Practice location:
  • Phone: 505-554-5395
  • Fax: 505-658-8958
Mailing address:
  • Phone: 505-554-5395
  • Fax: 505-658-8958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HANNAH ROMERO
Title or Position: OWNER
Credential: NP
Phone: 505-554-5385