| Doctor Name: | MRS. LYNNE K REVENO |
| NPI Number: | 1053479733 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN CNS |
| License Number: | 101852 |
| Business Practice Address: | 1 W Foster St Melrose, MA - 021763810 |
| Business Phone Number: | 6179577944 |
| Business Fax Number: | 7816657543 |
| Mailing Address: | 8 Meadowview Rd, MELROSE |
| State: | MA |
| Postal Code: | 021762913 |
| Phone Number: | 6179577944 |
| Fax Number: | 7816657543 |
| NPI Enumeration Date: | 12/05/2006 |
| NPI Last Update Date: | 08/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | 101852 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |