# SLB REVIVE AND THRIVE WELLNESS P.C.

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

## Provider details

- **NPI number:** 1316882566
- **Authorized official:** NICOLE LYNN PARKER MSN, APRN, PMHNP-BC (FOUNDER)
- **Authorized official phone:** (314) 948-4715

## Contact information

- **Practice address:** 400 CHESTERFIELD CTR STE 457, CHESTERFIELD, MO 63017-4834
- **Practice address phone:** (314) 948-4715
- **Practice address fax:** (314) 579-3354
- **Mailing address:** 400 CHESTERFIELD CTR STE 457, CHESTERFIELD, MO 63017-4834
- **Mailing address phone:** (314) 948-4715
- **Mailing address fax:** (314) 579-3354

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/23/2026
- **Last updated:** 04/23/2026