Healthcare Provider Details

I. General information

NPI: 1386443125
Provider Name (Legal Business Name): NDO WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2637 W HORIZON RIDGE PKWY STE 130
HENDERSON NV
89052-4835
US

IV. Provider business mailing address

PO BOX 232378
LAS VEGAS NV
89105-2378
US

V. Phone/Fax

Practice location:
  • Phone: 702-918-7771
  • Fax: 702-745-2113
Mailing address:
  • Phone: 702-918-7771
  • Fax: 702-745-2113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: LAUREN B. PARKER
Title or Position: OWNER
Credential: FNP-C
Phone: 702-918-7771