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Individual
LOGAN REVILL
Active
Individual
LOGAN REVILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
227095
OK
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
R0133810
OK
Other
Enumeration date
11/03/2025
Last updated
03/19/2026
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