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 is a Physician Assistant 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

Other providers in Mooresville