Individual
MS. CHERIAL LASHAWN REVELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
6801 RIVER RD, SUITE 106, COLUMBUS, GA 31904-3352
(706) 566-4288
Mailing address
7982 NATURE TRL, COLUMBUS, GA 31904-2156
(706) 761-1661
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN127665
GA
163WG0000X
General Practice Registered Nurse
RN127665
GA
363LF0000X
Family Nurse Practitioner
Primary
RN127665
GA
Other
Enumeration date
01/08/2008
Last updated
02/17/2014
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