Individual provider · Type 1 NPI
Vicki Sue Revak, MSN, AGAC-BC
Gerontology Nurse Practitioner · Horsham, PA
NPI number
1972075356
Active
Practice location
680 Blair Mill Rd
Horsham, PA 19044-2223
Mailing address
10757 Pont Rd
Albion, PA 16401-8605
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | SP019667 (PA) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1972075356
Vicki Sue Revak, MSN, AGAC-BC's National Provider Identifier is 1972075356, issued on Dec 22, 2018. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Horsham, PA. The record was last updated on Jun 24, 2019.