Individual
CHERIE L. REVERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2451 FILLINGIM ST, BLDG. C, MOBILE, AL 36617-2238
(251) 445-8242
(251) 445-8250
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 445-8242
(251) 445-8250
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-052358
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08332509
—
MS
01
—
51507901
BLUE CROSS
AL
01
—
51518496
BLUE CROSS
AL
05
—
890009050
—
AL
05
—
891006050
—
AL
Enumeration date
05/24/2006
Last updated
05/12/2015
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