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Organization
REVITALIZE HEALTH
Active
Organization
REVITALIZE HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER KING FNP (CEO)
(208) 763-8920
Entity
Organization
Contact information
Practice address
250 NORTHWEST BLVD STE 200, COEUR D ALENE, ID 83814-2973
(208) 763-8920
(208) 203-0947
Mailing address
4204 N MOCCASIN RD, COEUR D ALENE, ID 83815-8826
(208) 763-8920
(208) 763-8920
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/29/2026
Last updated
07/29/2026
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