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General NPI Number Information
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NPI Number | 1295664290
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Entity Type | Organization
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Legal Business Name | REVIVE WELLNESS NC
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Dates
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Enumeration Date | 05/15/2026
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Last Update Date | 05/15/2026
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Provider Practice Location Address
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Address Line | 7633 KNIGHTDALE BLVD STE 106B
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City | KNIGHTDALE
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State | NC
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Zip | 27545-9015
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Country | US
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Telephone | 919-521-0833
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Fax |
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Provider Business Mailing Address
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Address Line | 7633 KNIGHTDALE BLVD STE 106B
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City | KNIGHTDALE
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State | NC
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Zip | 27545-9015
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Country | US
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Telephone | 919-521-0833
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Fax |
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Authorized Official
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Title or Position | NURSE PRACITIONER/OWNER
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Name | MRS. KARI ANNE SPENCER
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Credential | FNP-C
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Telephone | 919-521-0833
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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