Organization
REVIVE PSYCHIATRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN KAMINAR APRN, PMHNP-BC (OWNER)
(580) 754-4164
Entity
Organization
Contact information
Practice address
720 BRYAN DR STE C, DURANT, OK 74701-7032
(580) 754-4164
(580) 359-0468
Mailing address
720 BRYAN DR STE C, DURANT, OK 74701-7032
(580) 754-4164
(580) 359-0468
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/18/2025
Last updated
09/26/2025
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