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Individual

DR. STEPHANIE MARIE REVELS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3135 PROSPECT AVE, KANSAS CITY, MO 64128-1552
(816) 209-1237
(816) 577-5091
Mailing address
102 WOODMONT BLVD STE 600, NASHVILLE, TN 37205-5250
(615) 314-5257
(615) 692-0547

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
04-28042
KS
207Q00000X
Family Medicine Physician
Primary
R3H32
MO

Other

Enumeration date
05/30/2006
Last updated
08/05/2022
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