REVOLUTION LONGEVITY AND WELLNESS LLC
NPI 1932096674
Nurse Practitioner in Stratham, NH

Q: What is Revolution Longevity And Wellness LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since June 23, 2025CLIA 30D2321644 · Waiver

91 PORTSMOUTH AVE, STRATHAM, NH 03885(603) 793-5969 Get Directions Write a Review

NPPES record last updated: June 23, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Revolution Longevity And Wellness Llc NPPES

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

REVOLUTION LONGEVITY AND WELLNESS LLC (NPI 1932096674) is a healthcare organization registered as a nurse practitioner in Stratham, New Hampshire and active in the NPI registry since June 2025. The organization holds a CLIA Waiver certificate valid through April 7, 2027 and lists Ann Fisher, Owner/np, as its authorized official.

NPPES Registry Identity

NPI1932096674

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameREVOLUTION LONGEVITY AND WELLNESS LLC

Location Address91 PORTSMOUTH AVEStratham, NH 03885-2468

Mailing Address91 Portsmouth AveStratham, NH 03885-2468 · (603) 793-5969

Phone(603) 793-5969

Organization SubpartNo

Authorized OfficialAnn FisherOwner/np · (603) 793-5969

Enumeration DateJune 23, 2025

NPPES CertifiedJune 23, 2025

✔ NPI 1932096674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

91 PORTSMOUTH AVE, Stratham, NH 03885

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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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 30D2321644

Revolution Longevity And Wellness LLC · Stratham, NH

Active · expires Apr 7, 2027

CLIA Number30D2321644

Laboratory TypePractitioner Other

Certificate Effective DateApril 8, 2025

Certificate Expiration DateApril 7, 2027

Laboratory DirectorAnn Fisher

Laboratory Phone(603) 793-5969

Laboratory LocationRevolution Longevity And Wellness LLC91 Portsmouth Ave, Ste E, Stratham, NH 03885

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Revolution Longevity And Wellness LLC's NPI number?

The NPI number for Revolution Longevity And Wellness LLC is 1932096674. It was assigned to this organization in the NPPES registry on June 23, 2025.

Where is Revolution Longevity And Wellness LLC located?

Revolution Longevity And Wellness LLC is located at 91 Portsmouth Ave, Stratham, NH 03885. The listed phone number is (603) 793-5969.

What is Revolution Longevity And Wellness LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Revolution Longevity And Wellness LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 30D2321644) is associated with this NPI, valid through April 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Revolution Longevity And Wellness LLC was last updated on June 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.