LINDA DESRUISSEAU-REVIS (NPI# 1912459728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912459728 |
| Entity Type | Individual |
| Full Name | LINDA DESRUISSEAU-REVIS |
| Credential | APRN, CNP |
| Practice Address |
3131 N Mcmullen Booth Rd Clearwater FL 33761-2008 |
| Mailing Address |
1301 2nd Ave Sw Largo FL 33770-2298 |
| Practice Telephone | 7277268871 |
| Practice Fax Number | 7275889478 |
| Mailing Telephone | 7275818767 |
| Mailing Fax Number | 7275858542 |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2019-12-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP9490973 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | AETNA | 5030780 | 01 |
| FL | UNITED | 6287578 | 01 |
| FL | 101395400 | 05 | |
| FL | CIGNA | 8270292 | 01 |
| FL | FLORIDA BLUE | 48EHI | 01 |
| Street Address |
3131 N MCMULLEN BOOTH RD |
| City | CLEARWATER |
| State | FL |
| Zip Code | 33761-2008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821097163 | R & F Inc | Occupational Therapist | 3131 N Mcmullen Booth Rd, Suite 102, Clearwater, FL 33761-2008 | 2005-07-19 |
| 1295293173 | Harmony Vance | Nurse Practitioner | 3131 N Mcmullen Booth Rd, Clearwater, FL 33761-2008 | 2019-03-09 |
| 1770080046 | Samantha Anne Wannos | Nurse Practitioner | 3131 N Mcmullen Booth Rd, Clearwater, FL 33761 | 2018-04-12 |
| 1366982837 | Belongie Orthopedics LLC | Orthopaedic Surgery | 3131 N Mcmullen Booth Rd, C/o Dcmg, Clearwater, FL 33761-2008 | 2017-03-03 |
| 1205283942 | Eben A Smith | Nurse Practitioner | 3131 N Mcmullen Booth Rd, Clearwater, FL 33761 | 2016-05-23 |
| 1104209634 | Victoria Lynn James | Nurse Practitioner | 3131 N Mcmullen Booth Rd, Clearwater, FL 33761-2008 | 2015-07-01 |
| 1437536257 | Alaina Lee Gregory | Physician Assistant | 3131 N Mcmullen Booth Rd, Clearwater, FL 33761-2008 | 2015-04-30 |
| 1164857926 | Karen Lynn Jeziorski | Licensed Practical Nurse | 3131 N Mcmullen Booth Rd, Clearwater, FL 33761-2008 | 2013-09-11 |
| 1558603613 | Alexander K Malone | Otolaryngology | 3131 N Mcmullen Booth Rd, Clearwater, FL 33761-2008 | 2013-03-26 |
| 1710224878 | Brittany Christina Maglio | Nurse Practitioner | 3131 N Mcmullen Booth Rd, Clearwater, FL 33761-2008 | 2013-01-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184210 | Sandra Shanice Campisi | Behavior Technician | 29228 Us-19 N, Clearwater, FL 33761 | 2020-11-02 |
| 1659838449 | Branden Kleehammer | Occupational Therapy Assistant | 6941 300th Ave N, Clearwater, FL 33761 | 2019-02-27 |
| 1063901403 | Sheleaha C Egly I | Behavior Technician | 29288 Us Highway 19 N, Clearwater, FL 33761 | 2018-05-01 |
| 1760979629 | Melissa Irene Valentine | Social Worker | 6997 300th Ave North, Clearwater, FL 33761 | 2018-04-17 |
| 1871011049 | Maria's Adult Day Care Center | Clinic/Center | 26224 Us Highway 19 N., Clearwater, FL 33761 | 2017-09-07 |
| 1962933739 | Robert Hudson | Occupational Therapist | 3463 Northridge Dr, Clearwater, FL 33761 | 2017-03-23 |
| 1366985582 | Brandon Chad Brown | Physician Assistant | 29277 Hwy 19 North, Clearwater, FL 33761 | 2016-11-19 |
| 1730575606 | Layne S Winker | Physician Assistant | 26812 Us 19 N # 19, Clearwater, FL 33761 | 2015-04-08 |
| 1407254907 | M Christina Memoli Od Pa | Optometrist | 27901 Us 19 N, Clearwater, FL 33761 | 2014-12-15 |
| 1952729774 | Gina Pietras Spohn | Dermatology | 3165 N Mcmullen Booth Rd Bldg B, Clearwater, FL 33761 | 2014-03-29 |
| Find all providers in zip 33761 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174139521 | Elizabeth Adams | Nurse Practitioner | 2515 Bramblewood Dr E, Clearwater, FL 33763-1212 | 2020-09-21 |
| 1912517210 | Lynn Hutto | Nurse Practitioner | 2067 Montclair Rd, Clearwater, FL 33763-4230 | 2020-08-03 |
| 1508403676 | Jorge Duenas Giuria | Nurse Practitioner | 2251 Lauren Ln, Clearwater, FL 33759-1438 | 2019-12-07 |
| 1679124259 | Christina M Battafarano | Nurse Practitioner | 19995 Us 19 N, Clearwater, FL 33764-5013 | 2019-09-24 |
| 1568926863 | Brianne Bender | Nurse Practitioner | 1305 S Fort Harrison Ave Ste E, Clearwater, FL 33756-3301 | 2019-01-31 |
| 1114401007 | Elizabeth Kurman | Nurse Practitioner | 25 N Belcher Rd Apt C120, Clearwater, FL 33765-3206 | 2018-09-18 |
| 1023509965 | Judith Lynn Pierce | Nurse Practitioner | 1536 Nursery Rd, Clearwater, FL 33756-2319 | 2018-05-26 |
| 1780191551 | Dana Schnell | Nurse Practitioner | 29605 Us Highway 19 N Ste 170, Clearwater, FL 33761-1538 | 2018-01-03 |
| 1154850683 | Laronda Lynn Lang | Nurse Practitioner | 3165 N Mcmullen Booth Rd Bldg H, Clearwater, FL 33761-2034 | 2017-06-08 |
| 1861863037 | Michael Gordon Dilling | Nurse Practitioner | 18167 Us Highway 19 N # 337, Suite 650, Clearwater, FL 33764-3528 | 2015-10-14 |
| Find all providers in CLEARWATER | ||||
| City | CLEARWATER |
| Zip Code | 33761 |
Please comment or provide details below to improve the information on LINDA DESRUISSEAU-REVIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.