Revels, Tisa Marie

Revels, Tisa Marie is an sole proprietor health care provider with primary practice located at 4001 Kresge Way Suite 200, Louisville KY 40207-4640. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Technologists, Technicians & Other Technical Service Providers / Surgical Assistant. Technologists, Technicians & Other Technical Service Providers / Surgical Assistant is her primary health care specialty. Revels, Tisa Marie can be contacted via phone (502) 895-1995.

Contact Information

Primary practice address
4001 Kresge Way Suite 200 Louisville KY 40207-4640
Phone: (502) 895-1995
Fax: (502) 895-6479
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X SA029 Kentucky
Technologists, Technicians & Other Technical Service Providers / Surgical Assistant 246ZC0007X SA029 Kentucky

Profile Details

NPI number 1750424859
LBN Legal business name Revels, Tisa Marie
Credentials SA-C, KCSA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 15th, 2007
Last updated Mar 3rd, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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