Healthcare Provider Details

I. General information

NPI: 1104528686
Provider Name (Legal Business Name): HEAL AND GLOW WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 E FLAMINGO RD STE 202
LAS VEGAS NV
89119-5124
US

IV. Provider business mailing address

2121 E FLAMINGO RD STE 202
LAS VEGAS NV
89119-5124
US

V. Phone/Fax

Practice location:
  • Phone: 712-790-0235
  • Fax:
Mailing address:
  • Phone: 712-790-0235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SANDRA RAMSEY
Title or Position: PROVIDER
Credential: APRN
Phone: 702-362-0210