MS. Jacqueline Revello, MA, RN

NPI #1003084369 in Divide, Colorado

Provider Information

NPI Number: 1003084369
Entity Type: Individual
Name: MS. Jacqueline Revello, MA, RN
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Registered Nurse
Credential: MA, RN
Enumeration Date: Feb 20, 2008
Last Updated: Feb 10, 2017

Practice Location

Address: 11115 W. HWY 24, UNIT 2C
City: Divide
State: Colorado
ZIP Code: 80814
Phone: (719) 687-6416

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Registered Nurse	163W00000X	Primary

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