Provider Demographics
NPI:1265646285
Name:REVELS, SHARON MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:MARIE
Last Name:REVELS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 CATTLEMEN RD STE 104
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6057
Mailing Address - Country:US
Mailing Address - Phone:941-379-7777
Mailing Address - Fax:941-379-1888
Practice Address - Street 1:3333 CATTLEMEN RD STE 104
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6057
Practice Address - Country:US
Practice Address - Phone:941-379-7777
Practice Address - Fax:941-379-1888
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1087842363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily