Healthcare Provider Details

I. General information

NPI: 1801729652
Provider Name (Legal Business Name): MAIDEN AESTHETICS AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1404 EWING PARK LOOP STE 112
MIDLOTHIAN VA
23113-3450
US

IV. Provider business mailing address

1248 CARMIA WAY # 1063
NORTH CHESTERFIELD VA
23235-4750
US

V. Phone/Fax

Practice location:
  • Phone: 804-699-9677
  • Fax:
Mailing address:
  • Phone: 804-699-9677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LUDNA MAIDEN
Title or Position: OWNER
Credential: NP
Phone: 804-699-9677