Organization · Type 2 NPI

Renova Wellness & Aesthetics LLC

Nurse Practitioner · Bentonville, AR

NPI number 1407783764 Active

Practice location

808 S Walton Blvd Ste 2
Bentonville, AR 72712-6235

Fax (479) 341-9337

Mailing address

5101 S Sloan Cir
Rogers, AR 72758-4617

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XNone listed

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

3 other providers at this address

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About NPI 1407783764

Renova Wellness & Aesthetics LLC's National Provider Identifier is 1407783764, issued on May 8, 2026. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Bentonville, AR. The record was last updated on Sep 15, 2026.