Individual
MRS. BROOKE LOGSDON REVELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
555 NW LAKE WHITNEY PL STE 103, PORT SAINT LUCIE, FL 34986-1623
(772) 468-0042
Mailing address
555 NW LAKE WHITNEY PL STE 103, PORT SAINT LUCIE, FL 34986-1623
(772) 468-0042
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
APRN11033176
FL
363LF0000X
Family Nurse Practitioner
APRN11033176
FL
363LW0102X
Women's Health Nurse Practitioner
APRN11033176
FL
Other
Enumeration date
05/09/2024
Last updated
08/03/2025
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