Individual
TASHA REVOLUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
555 S FLOYD ST, LOUISVILLE, KY 40202-3822
(502) 533-3990
Mailing address
555 S FLOYD ST, LOUISVILLE, KY 40202-3822
(502) 533-3990
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
1163808
KY
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/12/2024
Last updated
08/13/2025
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