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Individual

REVA MIN VRANA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(503) 623-9289
(503) 623-7560
Mailing address
2006 STEFON CT SE, SALEM, OR 97302-2185
(415) 370-1692

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
801962
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
23519
CA

Other

Enumeration date
05/24/2013
Last updated
10/18/2022
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