REVITALIZED WELLNESS NPI 1104682590

NPI Information

NPI: 1104682590
Provider Name: REVITALIZED WELLNESS
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
1043 MEADOW RUN DR
DUNCANVILLE, TX
ZIP 75137
Phone: (972) 838-0652
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REVITALIZED WELLNESS is a psychiatric/mental health nurse practitioner in Duncanville, TX. REVITALIZED WELLNESS NPI is 1104682590. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1043 MEADOW RUN DR
DUNCANVILLE, TX
ZIP 75137-599
Phone: (972) 838-0652

The provider's authorized official is Charmeka Lipscomb .
The authorized official title is Owner and has the following contact phone number (972) 838-0652.

The enumeration date for this NPI number is 2/23/2024 and was last updated on 2/23/2024.

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
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

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: 5/5/2024

NPI Synchronization or Removal

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