Individual provider · Type 1 NPI

Tisa Marie Revels, SA-C, KCSA

Surgical Assistant · Louisville, KY

NPI number 1750424859 Active

Practice location

4001 Kresge Way, Suite 200
Louisville, KY 40207-4640

Call (502) 895-1995 Map

Fax (502) 895-6479

Mailing address

PO Box 950248
Louisville, KY 40295-0248

Specialties and licenses

TaxonomyCodeLicense
Specialist 174400000XSA029 (KY)
Surgical Assistant Primary 246ZC0007XSA029 (KY)

Surgical Assistant: A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in h…

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About NPI 1750424859

Tisa Marie Revels, SA-C, KCSA's National Provider Identifier is 1750424859, issued on Feb 15, 2007. The primary taxonomy on file is Surgical Assistant (246ZC0007X), and the practice location is in Louisville, KY. The record was last updated on Mar 3, 2016.