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

Revitalize Hydration Therapy, LLC

Organization Gerontology Nurse Practitioner · NPI 1285261123

Revitalize Hydration Therapy, LLC is a Gerontology Nurse Practitioner in Flowood, Mississippi. 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.

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Practice location Address checks out

885 Liberty Rd Ste 300
Flowood, MS 39232-9006
Phone: (601) 213-0069
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X

Record details

NPI number1285261123
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennye Mardis — Staff · (601) 213-0069
NPI enumeratedMarch 23, 2020
Last updated in NPPESNovember 10, 2020
Certification dateOctober 30, 2020
Mailing address885 Liberty Rd Ste 300, Flowood, MS 39232-9006

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