Organization
REVITALIZE HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HEATHER KING NP (CEO)
(208) 763-8920
Entity
Organization
Contact information
Practice address
913 W CANFIELD AVE, COEUR D ALENE, ID 83815-9764
(208) 763-8920
(208) 203-0947
Mailing address
913 W CANFIELD AVE, COEUR D ALENE, ID 83815-9764
(208) 763-8920
(208) 203-0947
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/15/2025
Last updated
09/15/2025
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