Individual
SHANNON REVIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP-BC, RN
Contact information
Practice address
104 W MAIN ST, ELKTON, MD 21921-5509
(410) 996-8990
(410) 996-8992
Mailing address
104 W MAIN ST, ELKTON, MD 21921-5509
(410) 996-8990
(410) 996-8992
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R230122
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184029720
—
PA
Enumeration date
10/24/2014
Last updated
03/27/2018
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