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Individual

MRS. APRIL REVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
9755 WEST STATE HWY 22, RATCLIFF, AR 72951
(479) 635-5300
(479) 635-2010
Mailing address
P.O. BOX 130, RATCLIFF, AR 72951
(479) 635-5300
(479) 635-2010

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A01858
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
156465758
AR
01
5Y352
AR BCBS
AR
Enumeration date
07/26/2006
Last updated
07/09/2015
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