=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780568808
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOL LEGACY INTEGRATIVE WELLNESS LUTHER PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2025
-----------------------------------------------------
Last Update Date | 08/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1000 NEVADA WAY STE 106B
-----------------------------------------------------
City | BOULDER CITY
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89005-1828
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-416-6660
-----------------------------------------------------
Fax | 702-416-6660
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 909 LITTLE RAVEN ST
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89002-0401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-416-6660
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | NATALIE LUTHER
-----------------------------------------------------
Credential | PMHNP-BC
-----------------------------------------------------
Telephone | 702-416-6660
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------