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Revitalize Wellness, Llc
Psychiatric/Mental Health Nurse Practitioner in Tipton, Indiana
NPI 1306625116

Revitalize Wellness, Llc is a Psychiatric/Mental Health Nurse Practitioner based in Tipton, IN and is specialized in Psychiatric/Mental Health. Revitalize Wellness, Llc practices in Tipton, IN. The NPI Number for Revitalize Wellness, Llc is 1306625116 and holds a License No. (Indiana).

The current practice location address for Revitalize Wellness, Llc is 5114 E 200 S, Tipton, IN and can be reached out via phone at 317-650-2505.

Location: 5114 E 200 S, Tipton, IN, 46072-8479
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1306625116
Provider Name
Revitalize Wellness, Llc
Credential
Provider Entity Type
Organization
Address
5114 E 200 S, Tipton, IN, 46072-8479
Phone Number
317-650-2505
Fax Number
Provider Enumeration Date
09/22/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
5114 E 200 S
City
Tipton
State
Indiana
Zip
46072-8479
Phone Number
317-650-2505
Fax Number
person
Provider Business Mailing Address Details
Address
5114 E 200 S
City
Tipton
State
Indiana
Zip
46072-8479
Phone Number
317-650-2505
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
()
Definition
Definition to come...
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