Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revive Skin and Wound PLLC

Organization Physician Assistant · NPI 1144186404

Revive Skin and Wound PLLC provides Physician Assistant services in Mooresville, North Carolina. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

116 Round Keep Ln
Mooresville, NC 28117-8091
Phone: (704) 727-6153
Fax: (213) 559-9971
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1144186404
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Hull — Owner/Provider · (704) 727-6153
NPI enumeratedDecember 30, 2025
Last updated in NPPESDecember 30, 2025
Certification dateDecember 30, 2025
Mailing address116 Round Keep Ln, Mooresville, NC 28117-8091

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