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NPI Code Detail

MEDICARE: NUSKIN BIOLOGICS LLC

MEDICARE: NUSKIN BIOLOGICS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WW0000XWound Care Registered Nurse

General Provider Information

NPI Number : 1851961718
Entity Type Code : Organization
Provider Name (Legal Business Name) : NUSKIN BIOLOGICS LLC
Provider Business Mailing Address
First Line : 4220 SAXTON GREEN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89141-4354
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 801 S RANCHO DR STE B1B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-3871
Country : US
Telephone Number : 702-400-0517
Fax Number :
Authorized Official
Title or Position : OWNER
Name : STANLEY KIDIAVAYI
Credential : NP
Telephone Number : 702-304-2144
Provider Enumeration Date : 07/01/2021
Last Update Date : 07/01/2021

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Directions to “NUSKIN BIOLOGICS LLC ” Practice Location

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