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General NPI Number Information
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NPI Number | 1912832932
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Entity Type | Organization
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Legal Business Name | REVIVE WELLNESS AND AESTHETICS
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Dates
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Enumeration Date | 06/13/2026
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Last Update Date | 06/13/2026
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Provider Practice Location Address
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Address Line | 1939 TATE BLVD SE
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City | HICKORY
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State | NC
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Zip | 28602-1430
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Country | US
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Telephone | 828-457-8987
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Fax | 828-571-5613
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Provider Business Mailing Address
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Address Line | 4020 PLEASANT GROVE CHURCH RD
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City | SHELBY
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State | NC
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Zip | 28150-2842
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Country | US
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Telephone | 828-457-8987
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Fax | 828-571-5613
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Authorized Official
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Title or Position | OWNER, NURSE PRACTITIONER
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Name | SARA PIERCY
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Credential | NP
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Telephone | 828-457-8987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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