Organization
REVIVE HEALTH AND WELLNESS, LLC
Active
Organization
REVIVE HEALTH AND WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI J WHITE NP (OWNER)
(228) 324-5347
Entity
Organization
Contact information
Practice address
2112 BIENVILLE BLVD STE M1, OCEAN SPRINGS, MS 39564-3027
(228) 324-5347
Mailing address
17804 RIVERWALK DRIVE, VANCLEAVE, MS 39565
(228) 324-5347
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/06/2022
Last updated
09/01/2026
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