Organization · Type 2 NPI
Revive Hydration PLLC
Psychiatric/Mental Health Nurse Practitioner · Red Bud, IL
NPI number
1831003250
Active
Practice location
505 S Main St
Red Bud, IL 62278-1212
Mailing address
4740 Kane Hill Rd
Ellis Grove, IL 62241-1728
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
2 other providers at this address
About NPI 1831003250
Revive Hydration PLLC's National Provider Identifier is 1831003250, issued on Oct 1, 2026. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Red Bud, IL. The record was last updated on Oct 1, 2026.