Individual
COURTNEY ROSE REVOIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2605 S ONEIDA ST STE 107, GREEN BAY, WI 54304-5331
(844) 493-1052
Mailing address
2605 S ONEIDA ST STE 107, GREEN BAY, WI 54304-5331
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
230013
WI
363LF0000X
Family Nurse Practitioner
Primary
14923-33
WI
Other
Enumeration date
11/22/2023
Last updated
03/14/2024
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