REVIVE MEDICAL SPA LLC NPI 1467175943

NPI Information

NPI: 1467175943
Provider Name: REVIVE MEDICAL SPA LLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
1905 COWLES ST STE B
FAIRBANKS, AK
ZIP 99701
Phone: (907) 371-1766
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REVIVE MEDICAL SPA LLC is a multi-specialty clinic center in Fairbanks, AK. REVIVE MEDICAL SPA LLC NPI is 1467175943. The provider is registered as an organization entity type.

The provider's business location address is:

1905 COWLES ST STE B
FAIRBANKS, AK
ZIP 99701-914
Phone: (907) 371-1766
Fax: (907) 531-7365

The provider's authorized official is Karolina Priebe .
The authorized official title is Owner/partner/nurse Practitioner and has the following contact phone number (907) 371-1766.

The enumeration date for this NPI number is 9/21/2022 and was last updated on 9/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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