=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063206787
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KARMA WELLNESS & AESTHETICS, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2025
-----------------------------------------------------
Last Update Date | 04/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 425B S CHESTNUT ST
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27536-4201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-598-1059
-----------------------------------------------------
Fax | 252-598-0779
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 425B S CHESTNUT ST
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27536-4201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-598-1059
-----------------------------------------------------
Fax | 252-598-0779
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MANAGER
-----------------------------------------------------
Name | ANITA E ROGERS
-----------------------------------------------------
Credential | PA-C
-----------------------------------------------------
Telephone | 252-598-1059
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------