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

Revivify Wound Care and Soft Tissue Specialist

Organization Family Nurse Practitioner · NPI 1134016397

Revivify Wound Care and Soft Tissue Specialist is a Family Nurse Practitioner in Las Vegas, Nevada. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

4533 Merkel Bluff St
Las Vegas, NV 89147-5128
Phone: (702) 886-2269
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 number1134016397
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Juan Gutierrez — Owner · (702) 886-2269
NPI enumeratedJune 20, 2025
Last updated in NPPESJuly 10, 2025
Certification dateJuly 10, 2025
Mailing address4533 Merkel Bluff St, Las Vegas, NV 89147-5128

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