Individual
ROSE REVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 S PARKSIDE DR, COLORADO SPRINGS, CO 80910-3130
(719) 572-6340
Mailing address
220 RUSKIN DR, COLORADO SPRINGS, CO 80910-2522
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
204013
CO
Other
Enumeration date
06/01/2012
Last updated
06/05/2012
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