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NPI Code Detail

MEDICARE: REBECCA REVELL FNP-BC

MEDICARE:   REBECCA  REVELL  FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN185002GA
2363LX0001XObstetrics & Gynecology Nurse PractitionerRN185002GA

General Provider Information

NPI Number : 1952849721
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA REVELL FNP-BC
Provider Business Mailing Address
First Line : 414 5TH AVE
Second Line :
City : ALBANY
State : GA
Zip : 31701-1976
Country : US
Telephone Number : 229-883-4555
Fax Number :
Provider Business Practice Location Address
First Line : 414 5TH AVE
Second Line :
City : ALBANY
State : GA
Zip : 31701-1976
Country : US
Telephone Number : 229-883-4555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2017
Last Update Date : 06/16/2022

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Directions to “ REBECCA REVELL FNP-BC” Practice Location

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