Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

RENOVA WELLNESS & AESTHETICS LLC
NPI 1407783764
Nurse Practitioner in Bentonville, AR

Q: What is Renova Wellness & Aesthetics LLC's NPI number?

The NPI number for Renova Wellness & Aesthetics LLC is 1407783764. It was assigned to this organization in the NPPES registry on May 8, 2026.

Q: What is Renova Wellness & Aesthetics LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since May 08, 2026

808 S WALTON BLVD STE 2, BENTONVILLE, AR 72712(479) 593-3020(479) 341-9337 Get Directions Write a Review

NPPES record last updated: September 15, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 15, 2026, May 8, 2026 (2 updates tracked since 2026).

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About Renova Wellness & Aesthetics Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RENOVA WELLNESS & AESTHETICS LLC (NPI 1407783764) is a healthcare organization registered as a nurse practitioner in Bentonville, Arkansas and active in the NPI registry since May 2026. The organization lists Brant Kwyzla, Owner, as its authorized official.

NPPES Registry Identity

NPI1407783764

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameRENOVA WELLNESS & AESTHETICS LLC

Location Address808 S WALTON BLVD STE 2Bentonville, AR 72712-6235

Mailing Address5101 S Sloan CirRogers, AR 72758-4617 · (479) 225-1750

Phone(479) 593-3020

Fax(479) 341-9337

Organization SubpartNo

Authorized OfficialBrant KwyzlaOwner · (479) 225-1750

Enumeration DateMay 8, 2026

Last NPPES UpdateSeptember 15, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 15, 2026

✔ NPI 1407783764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(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 with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

808 S WALTON BLVD STE 2, Bentonville, AR 72712

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHANIE DENISE MCGRATH LAC

Counselor (Mental Health)

808 S WALTON BLVD STE 2
BENTONVILLE, AR 72712

Benton County (479) 367-5657

HEIDI ELIZABETH DENNIS LPC

Counselor

808 S WALTON BLVD STE 2
BENTONVILLE, AR 72712

Benton County (479) 531-6528

THRIVE COLLECTIVE COUNSELING CENTER

Counselor (Mental Health)

808 S WALTON BLVD STE 2
BENTONVILLE, AR 72712

Benton County (479) 531-6528

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Renova Wellness & Aesthetics LLC's NPI number?

The NPI number for Renova Wellness & Aesthetics LLC is 1407783764. It was assigned to this organization in the NPPES registry on May 8, 2026.

Where is Renova Wellness & Aesthetics LLC located?

Renova Wellness & Aesthetics LLC is located at 808 S Walton Blvd Ste 2, Bentonville, AR 72712. The listed phone number is (479) 593-3020.

What is Renova Wellness & Aesthetics LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Renova Wellness & Aesthetics LLC was last updated on September 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.