Individual
MELISSA ROSE REVELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
315 W OAK ST, SPARTA, WI 54656-2150
(608) 269-6731
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
148085 7120
WI
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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