Kayla Revermann

NPI #1326648155 in O Fallon, Illinois

Provider Information

NPI Number: 1326648155
Entity Type: Individual
Name: Kayla Revermann
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Oct 30, 2020
Last Updated: Oct 30, 2020

Practice Location

Address: 1350 W US HIGHWAY 50
Address 2: PHARMACY
City: O Fallon
State: Illinois
ZIP Code: 62269
Phone: (618) 622-0507

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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