Individual
JENNA REVELLE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
1701 SOUTH BLVD E STE 190, ROCHESTER HILLS, MI 48307-6124
(248) 289-1509
Mailing address
1701 SOUTH BLVD E STE 190, ROCHESTER HILLS, MI 48307-6124
(248) 289-1509
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704273322
MI
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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