1. Home
  2. Directory
  3. Minnesota
  4. Zimmerman
  5. Family Medicine
  6. NPI Profile
Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

REVITALIZE YOUR WELLNESS
NPI 1194647172
Family Medicine in Zimmerman, MN

Active since July 29, 2026
12025 276TH AVE NW, ZIMMERMAN, MN 55398(651) 416-1301 Get Directions Write a Review

NPPES record added: July 29, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Revitalize Your Wellness NPPES

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

REVITALIZE YOUR WELLNESS (NPI 1194647172) is a healthcare organization registered as a family medicine in Zimmerman, Minnesota and active in the NPI registry since July 2026. The organization lists Mikayla Ellen Siemsen, Family Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1194647172
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameREVITALIZE YOUR WELLNESS
Location Address12025 276TH AVE NWZimmerman, MN 55398-8923
Mailing Address12025 276th Ave NwZimmerman, MN 55398-8923 · (651) 416-1301
Phone(651) 416-1301
Organization SubpartNo
Authorized OfficialMikayla Ellen SiemsenFamily Nurse Practitioner · (651) 416-1301
Enumeration DateJuly 29, 2026
NPPES CertifiedJuly 29, 2026
✔ NPI 1194647172 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
12025 276TH AVE NW, Zimmerman, MN 55398
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

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

MIKAYLA ELLEN SIEMSEN CNP
Nurse Practitioner (Primary Care)
12025 276TH AVE NW
ZIMMERMAN, MN 55398
Sherburne County (763) 350-6676

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 Revitalize Your Wellness's NPI number?

The NPI number for Revitalize Your Wellness is 1194647172. It was assigned to this organization in the NPPES registry on July 29, 2026.

Where is Revitalize Your Wellness located?

Revitalize Your Wellness is located at 12025 276th Ave NW, Zimmerman, MN 55398. The listed phone number is (651) 416-1301.

What is Revitalize Your Wellness's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Revitalize Your Wellness was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.