Provider Demographics
NPI:1740785344
Name:NOVA WELLNESS SOLUTIONS, LLC
Entity Type:Organization
Organization Name:NOVA WELLNESS SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KASIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHEER
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:907-252-7154
Mailing Address - Street 1:50618 BUOY AVE
Mailing Address - Street 2:
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-6409
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 N WILLOW ST STE 130
Practice Address - Street 2:
Practice Address - City:KENAI
Practice Address - State:AK
Practice Address - Zip Code:99611-7797
Practice Address - Country:US
Practice Address - Phone:907-770-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-26
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK895363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty