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General NPI Number Information
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NPI Number | 1679375018
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Entity Type | Organization
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Legal Business Name | KANVAS WELLNESS AND AESTHETICS, LLC
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 760 E MAIN ST STE 3
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2692
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Country | US
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Telephone | 615-706-0093
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Fax | 931-443-0174
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Provider Business Mailing Address
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Address Line | 760 E MAIN ST STE 3
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-2692
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Country | US
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Telephone | 615-706-0093
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Fax | 931-443-0174
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Authorized Official
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Title or Position | OWNER
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Name | EWELINA FREUDENBERGER
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Credential | FNP
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Telephone | 908-329-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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