# REVIVING WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053159996
- **Authorized official:** CARRIE MARTINSON NP (OWNER)
- **Authorized official phone:** (480) 923-9094

## Contact information

- **Practice address:** 3336 E CHANDLER HEIGHTS RD STE 123, GILBERT, AZ 85298-4263
- **Practice address phone:** (480) 923-9094
- **Mailing address:** 3336 E CHANDLER HEIGHTS RD STE 123, GILBERT, AZ 85298-4263
- **Mailing address phone:** (480) 923-9094

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/16/2024
- **Last updated:** 08/23/2024