IndividualActive
Jacqueline Revello, MA, RN
NPI 1003084369 · Registered Nurse · Divide, CO
Provider details
- NPI number
- 1003084369
- Entity type
- Individual
- Primary specialty
- Registered NurseNursing Service Providers
- Credential
- MA, RN
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Nursing Service Providers
- Counselor101Y00000X
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11115 W. Hwy 24, Unit 2c
Divide, CO 80814
Phone: (719) 687-6416
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 214
Divide, CO 80814-0214
Registry dates
- Enumerated
- 2008-02-20
- Last updated
- 2017-02-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.