Individual
DEBORAH REVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1683 BRONSON RD, TALLMADGE, OH 44278-3040
(330) 958-2384
(330) 249-7227
Mailing address
1683 BRONSON RD, TALLMADGE, OH 44278-3040
(330) 958-2384
(330) 249-7227
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
COA.09984-NP
OH
363LW0102X
Women's Health Nurse Practitioner
COA09984NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0083452
—
OH
Enumeration date
05/01/2013
Last updated
12/29/2018
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