Revive Aesthetics & Wellness

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

REVIVE AESTHETICS & WELLNESS

Practice address

1617 Laskin Road Unit 774B
Suite 136
Virginia Beach, VA 23451

Phone

(757) 302-8556

NPI assigned

Aug 1, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kirstie Robinson, NPNPI 1386344075

Title

Nurse Practitioner, Owner

Phone

(757) 302-8556

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kirstie Robinson, NP

  • Acute Care Nurse Practitioner
  • Chesapeake, VA
  • NPI 1386344075
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1144902180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 LASKIN ROAD UNIT 774B",
            "address_2": "SUITE 136",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23451",
            "telephone_number": "757-302-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 LASKIN ROAD UNIT 774B",
            "address_2": "SUITE 136",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23451",
            "telephone_number": "757-302-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE AESTHETICS & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-01",
        "last_updated": "2023-08-01",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "KIRSTIE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER, OWNER",
        "authorized_official_telephone_number": "757-302-8556",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Retro Medical LLC
• Bradley Reuter
• Rica Reuyan
• Revati Home Care LLC
• Yvette Revils
• Reviving Wellness Counseling
• Mariah Reann Rex
• Ana Reyes
• Christian Alex Reyes, PHARMD
• Lori Reyes, M.A., CCC-SLP

• Nurse Practitioner in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.