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

Revive Wellness and Rejuvenation LLC

Organization Family Nurse Practitioner · NPI 1184252678

Revive Wellness and Rejuvenation LLC provides Family Nurse Practitioner services in Glendale, Arizona. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

20229 N 67th Ave Ste C-A
Glendale, AZ 85308-6664
Phone: (602) 595-7836
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1184252678
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Graham — President · (602) 595-7836
NPI enumeratedMarch 30, 2020
Last updated in NPPESMay 1, 2020
Certification dateMay 1, 2020
Mailing address20229 N 67th Ave Ste C-A, Glendale, AZ 85308-6664

Other providers in Glendale