Individual
VICKI SUE REVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, AGAC-BC
Contact information
Practice address
680 BLAIR MILL RD, HORSHAM, PA 19044-2223
(267) 261-4413
Mailing address
10757 PONT RD, ALBION, PA 16401-8605
(814) 336-4865
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
SP019667
PA
Other
Enumeration date
12/22/2018
Last updated
06/24/2019
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