Organization
REVIVE CENTER FOR HEALTH & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MARIA SOUSA JEROME MSN, APRN, FNP-BC (NURSE PRACTITIONER)
(860) 375-2227
Entity
Organization
Contact information
Practice address
281 HARTFORD TPKE STE 106, VERNON, CT 06066-4760
(860) 375-2227
(860) 603-5080
Mailing address
281 HARTFORD TPKE STE 106, VERNON, CT 06066-4760
(860) 375-2227
(860) 603-5080
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134661531
—
CT
Enumeration date
03/09/2022
Last updated
02/25/2026
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