LUNA WELLNESS PLLC NPI 1902503451

NPI Information

  • NPI: 1902503451
  • Provider Name: LUNA WELLNESS, PLLC
  • Classification: Clinic/Center - 261QH0100X
  • Specialization: Health Service
  • Entity Type: Organization
  • Other Name: LUNA WELLNESS
  • CLIA Number: 04D2314027
  • Address: 5100 S THOMPSON ST STE 213
    SPRINGDALE, AR
    ZIP 72764
  • Phone: (479) 275-3520

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NPI Details

LUNA WELLNESS, PLLC is a health service clinic center in Springdale, AR. LUNA WELLNESS, PLLC NPI is 1902503451. The provider is registered as an organization entity type.
The provider Other Name Is Luna Wellness.

The provider's business location address is:

5100 S THOMPSON ST STE 213
SPRINGDALE, AR
ZIP 72764-941
Phone: (479) 275-3520
Fax: (479) 335-3405

The provider's authorized official is Taylor Beauregard Kelamis .
The authorized official title is Owner, Aprn and has the following contact phone number (479) 275-3520.

The CLIA number assigned to this NPI record is 04D2314027 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/14/2023 and was last updated on 11/8/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QH0100XClinic/CenterHealth ServiceYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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