Individual provider · Type 1 NPI

Jacqueline Revello, MA, RN

Registered Nurse · Divide, CO

NPI number 1003084369 Active

Practice location

11115 W. Hwy 24, Unit 2C
Divide, CO 80814

Mailing address

PO Box 214, 682 Simba Point
Divide, CO 80814-0214

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Registered Nurse Primary 163W00000XRN0188325 (CO)

Registered Nurse: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient…

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About NPI 1003084369

Jacqueline Revello, MA, RN's National Provider Identifier is 1003084369, issued on Feb 20, 2008. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Divide, CO. The record was last updated on Feb 10, 2017.