Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CORE REVIVE / SOUL REVIVE LLC
Active OrganizationCORE REVIVE / SOUL REVIVE LLC is a Nutrition Support Nurse organization located in PETALUMA, California. NPI 1154826980 is currently active in the NPPES registry. Verify at CMS.
Nutrition Support Nurse · PETALUMA, CA
Registration Details
- NPI Number
- 1154826980
- Provider Type
- Organization
- NPI Issued
- Mar 26, 2018 (8.4170291199873 yrs)
- Last Updated
- Jun 11, 2019
- Licenses
-
846331 (CA)846331 (CA)
Practice Information
- Address
-
16 QUEENS LNPETALUMA, CA, 949521047Browse CA providers · Browse ZIP 94952
- Phone
- 7075595347
- Primary Specialty
-
Nutrition Support Nurse
163WN1003X
- Additional Specialty
- Nutrition Support Nurse
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.