MEDICARE: REJUVENATED HEALTH & WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1063000479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REJUVENATED HEALTH & WELLNESS

Provider Business Mailing Address
First Line	:	PO BOX 10837
Second Line	:
City	:	FORT MOHAVE
State	:	AZ
Zip	:	86427-0837
Country	:	US
Telephone Number	:	928-201-8289
Fax Number	:

Provider Business Practice Location Address
First Line	:	5221 S HIGHWAY 95 STE 13
Second Line	:
City	:	FORT MOHAVE
State	:	AZ
Zip	:	86426-9244
Country	:	US
Telephone Number	:	928-234-7572
Fax Number	:

Authorized Official
Title or Position	:	FNP-BC
Name	:	DAYNA BLAKE
Credential	:
Telephone Number	:	928-201-8289

Provider Enumeration Date	:	01/02/2021
Last Update Date	:	07/06/2022

Similar Medicare Providers

1467439331 — DR. SCOTT IRWIN BOGGS DPM
Practice Location Address:

5221 HWY 95 , SUITE 10
FORT MOHAVE, AZ
86426-9244

Practice Phone: 928-788-3668
Practice Fax: 928-788-3670

1275579351 — MOHAVE HEARING LLC
Practice Location Address:

5221 S HWY 95 , SUITE 12
FT MOHAVE, AZ
86426-9244

Practice Phone: 928-768-9020
Practice Fax: 928-768-9030

1861908857 — KKTZ
Practice Location Address:

5221 HWY 95 STE 4
FORT MOHAVE, AZ
86426-9244

Practice Phone: 928-577-2533
Practice Fax:

1093288334 — KKTZ DENTAL PLLC
Practice Location Address:

5221 S HIGHWAY 95 STE 4
FORT MOHAVE, AZ
86426-9244

Practice Phone: 928-577-2533
Practice Fax: 928-577-2518

1033283635 — MS. MICHELLE JOANNE DRUMM-WILLIAMS LPN
Practice Location Address:

BLDG 9244, MARTIN LOOP
FORT BENNING, GA
31905

Practice Phone: 706-544-2633
Practice Fax:

1174688782 — DR. JANET R HARRIS PH.D. R.N.
Practice Location Address:

1077 PATCHELL ST
FORT DETRICK, MD
21702-9244

Practice Phone: 301-619-7073
Practice Fax: 301-619-7796

Directions to “REJUVENATED HEALTH & WELLNESS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.