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

Revival Wound Specialists LLC

Organization Nurse Practitioner · NPI 1689531709

Revival Wound Specialists LLC is a Nurse Practitioner in Perry, Georgia. Registered with an NPI since 2026.

In the registry since
2026
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

302 Bermuda Rdg
Perry, GA 31069-8756
Phone: (470) 979-7018
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1689531709
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dat Le — Owner · (470) 979-7018
NPI enumeratedJanuary 9, 2026
Last updated in NPPESJanuary 9, 2026
Certification dateJanuary 8, 2026
Mailing address302 Bermuda Rdg, Perry, GA 31069-8756

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