Revive Wellness and Aesthetics
NPI 1548940752ActiveOrganization· Nurse Practitioner, Family· Eagle, ID
Nurse Practitioner, Family in Eagle, Idaho, registered in NPPES in July 2023. The authorized official on file is Kelsey Martin, DNP, FNP-C, Owner/Nurse Practitioner.
Overview
| NPI | 1548940752 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 21, 2023 |
| Last updated in NPPES | Jul 21, 2023 |
| Certified by provider | Jul 21, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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