Organization · Type 2 NPI
Revive Mental Wellness LLC
Psychiatric/Mental Health Nurse Practitioner · Boise, ID
NPI number
1326756347
Active
Practice location
200 N 23rd St Ste 106
Boise, ID 83702-4969
Mailing address
1200 N Main St Unit 1623
Meridian, ID 83680-5065
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1326756347
Revive Mental Wellness LLC's National Provider Identifier is 1326756347, issued on Nov 8, 2022. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Boise, ID. The record was last updated on Nov 18, 2025.