# REVOLUTION WELLNESS NP IN ADULT HEALTH PLLC

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

## Provider details

- **NPI number:** 1235046392
- **Authorized official:** JELISA DOPWELL DNP (OWNER)
- **Authorized official phone:** (631) 997-8799

## Contact information

- **Practice address:** 296 S BICYCLE PATH, FARMINGVILLE, NY 11738-2124
- **Practice address phone:** (631) 997-8799
- **Mailing address:** 121 MAIN ST \# 1007, NORTHPORT, NY 11768-1721
- **Mailing address phone:** (631) 997-8799
- **Mailing address fax:** (209) 589-0420

## Taxonomy

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

## Other

- **Enumeration date:** 08/25/2026
- **Last updated:** 08/25/2026