Individual
REVEL SANDREL DEGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
117 S SPRING ST, LUVERNE, MN 56156-1916
(507) 283-9511
Mailing address
910 W HAVENS AVE, MITCHELL, SD 57301-3831
(605) 996-9686
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CP001721
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7311
MN BOARD OF NURSING
MN
Enumeration date
02/06/2020
Last updated
12/02/2020
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