Individual
BARBARA A REVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
450 BROOKLINE AVE, BOSTON, MA 02215-5418
(617) 632-5398
Mailing address
450 BROOKLINE AVE, BOSTON, MA 02215-5418
(617) 632-5398
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
TP004019X
PA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN179649
MA
Other
Enumeration date
02/05/2009
Last updated
12/30/2014
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