MEDICARE: RENU HEALTH & WELLNESS 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
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1902616618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENU HEALTH & WELLNESS LLC

Provider Business Mailing Address
First Line	:	10663 ENTRANCE ARCH ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89179-1813
Country	:	US
Telephone Number	:	702-302-6481
Fax Number	:	702-323-8553

Provider Business Practice Location Address
First Line	:	7997 W SAHARA AVE STE 103
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7901
Country	:	US
Telephone Number	:	702-302-6481
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDREW CHRISTIE
Credential	:	APRN
Telephone Number	:	702-302-6481

Provider Enumeration Date	:	01/13/2025
Last Update Date	:	04/14/2025

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