Individual
ALLISON REVILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Mailing address
5732 N 41ST AVE, PHOENIX, AZ 85019-1814
(928) 249-0339
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN175393
AZ
Other
Enumeration date
08/21/2015
Last updated
08/21/2015
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