Revive Skin and Wound Pllc
NPI #1144186404 in Mooresville, North Carolina
Provider Information
- NPI Number
- 1144186404
- Entity Type
- Organization
- Organization Name
- Revive Skin and Wound Pllc
- Primary Specialty
- Physician Assistant
- Enumeration Date
- Dec 30, 2025
- Last Updated
- Dec 30, 2025
Practice Location
- Address
- 116 ROUND KEEP LN
- City
- Mooresville
- State
- North Carolina
- ZIP Code
- 28117-8091
- Phone
- (704) 727-6153
Authorized Official
- Name
- MRS. JENNIFER MARIE HULL, PA-C
- Title
- OWNER/PROVIDER
- Phone
- (704) 727-6153
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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