Individual provider · Type 1 NPI
Jose Felix Revollo
Psychiatric/Mental Health Nurse Practitioner · Fort Washington, MD
NPI number
1013553502
Active
Practice location
703 Clamor Ct
Fort Washington, MD 20744-5170
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | R239041 (MD) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | R239041 (MD) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1013553502
Jose Felix Revollo's National Provider Identifier is 1013553502, issued on Nov 20, 2019. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Fort Washington, MD. The record was last updated on Jul 8, 2026.