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Organization
REVIVE SKIN AND WOUND PLLC
Active
Organization
REVIVE SKIN AND WOUND PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER MARIE HULL PA-C (OWNER/PROVIDER)
(704) 727-6153
Entity
Organization
Contact information
Practice address
116 ROUND KEEP LN, MOORESVILLE, NC 28117-8091
(704) 727-6153
(213) 559-9971
Mailing address
116 ROUND KEEP LN, MOORESVILLE, NC 28117-8091
(704) 727-6153
(213) 559-9971
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/30/2025
Last updated
12/30/2025
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