Provider Demographics
NPI:1235813114
Name:ADVANCED HEALTH REVISION PLLC
Entity type:Organization
Organization Name:ADVANCED HEALTH REVISION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:R
Authorized Official - Last Name:NEELY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:972-978-2317
Mailing Address - Street 1:661 E MAIN ST STE 200
Mailing Address - Street 2:BOX 118
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-3365
Mailing Address - Country:US
Mailing Address - Phone:972-903-4343
Mailing Address - Fax:800-782-4295
Practice Address - Street 1:231 S COLLINS RD
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-4624
Practice Address - Country:US
Practice Address - Phone:972-892-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty