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General NPI Number Information
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NPI Number | 1053221200
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Entity Type | Organization
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Legal Business Name | THRIVE REVIVAL DNP NURSING INC
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 1000 NEWBURY RD #210
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City | THOUSAND OAKS
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State | CA
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Zip | 91320
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Country | US
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Telephone | 805-309-1937
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Fax | 805-269-8951
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Provider Business Mailing Address
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Address Line | 30700 RUSSELL RANCH RD STE 250
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-9507
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Country | US
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Telephone | 805-309-1937
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Fax | 805-269-8951
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Authorized Official
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Title or Position | CEO
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Name | AMMIE EDEN KAHL
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Credential | FNP-BC
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Telephone | 805-309-1937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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