Revitalize IV Hydration and Wellness Clinc LLC
NPI 1871369272ActiveOrganization· Nurse Practitioner, Family· Jonesboro, AR
Nurse Practitioner, Family in Jonesboro, Arkansas, registered in NPPES in November 2023. The authorized official on file is Felica Johnson, NURSE PRACTITIONER, Fnp.
Overview
| NPI | 1871369272 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 28, 2023 |
| Last updated in NPPES | Dec 4, 2023 |
| Certified by provider | Dec 4, 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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