Organization · Type 2 NPI
Revive Wellness and Aesthetics
Family Nurse Practitioner · Eagle, ID
NPI number
1548940752
Active
Practice location
445 S Fitness Pl # 130
Eagle, ID 83616-6828
Mailing address
4253 N Sorrel Pl
Boise, ID 83703-3487
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
Other family nurse practitioner providers in Eagle
About NPI 1548940752
Revive Wellness and Aesthetics's National Provider Identifier is 1548940752, issued on Jul 21, 2023. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Eagle, ID. The record was last updated on Jul 21, 2023.