REVITALIZE IV HYDRATION AND WELLNESS CLINC LLC
NPI 1871369272
Nurse Practitioner - Family in Jonesboro, AR

Q: What is Revitalize IV Hydration And Wellness Clinc LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since November 28, 2023

2704 PHILLIPS DR STE A, JONESBORO, AR 72401(870) 955-5701(302) 209-5619 Get Directions Write a Review

NPPES record last updated: December 4, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Revitalize Iv Hydration And Wellness Clinc Llc NPPES

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

REVITALIZE IV HYDRATION AND WELLNESS CLINC LLC (NPI 1871369272) is a healthcare organization registered as a family in Jonesboro, Arkansas and active in the NPI registry since November 2023. The organization lists Felica Johnson, Fnp, as its authorized official.

NPPES Registry Identity

NPI1871369272

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameREVITALIZE IV HYDRATION AND WELLNESS CLINC LLC

Location Address2704 PHILLIPS DR STE AJonesboro, AR 72401-7399

Mailing Address2704 Phillips Dr Ste AJonesboro, AR 72401-7399 · (870) 955-5701 · Fax (302) 209-5619

Phone(870) 955-5701

Fax(302) 209-5619

Organization SubpartNo

Authorized OfficialFelica JohnsonFnp · (870) 273-4164

Enumeration DateNovember 28, 2023

Last NPPES UpdateDecember 4, 2023

NPPES CertifiedDecember 4, 2023

✔ NPI 1871369272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

2704 PHILLIPS DR STE A, Jonesboro, AR 72401

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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 2

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

IN MOTION PHYSICAL THERAPY, PLLC

Physical Therapist (Orthopedic)

2704 PHILLIPS DR STE A
JONESBORO, AR 72401

Craighead County (870) 761-9909

TIMOTHY WAYNE CLOUGH

Physical Therapist (Orthopedic)

2704 PHILLIPS DR STE A
JONESBORO, AR 72401

Craighead County (870) 761-9909

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 IV Hydration And Wellness Clinc LLC's NPI number?

The NPI number for Revitalize IV Hydration And Wellness Clinc LLC is 1871369272. It was assigned to this organization in the NPPES registry on November 28, 2023.

Where is Revitalize IV Hydration And Wellness Clinc LLC located?

Revitalize IV Hydration And Wellness Clinc LLC is located at 2704 Phillips Dr Ste A, Jonesboro, AR 72401. The listed phone number is (870) 955-5701.

What is Revitalize IV Hydration And Wellness Clinc LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Revitalize IV Hydration And Wellness Clinc LLC was last updated on December 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.