Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Vicki Sue Revak, MSN, AGAC-BC

Individual provider Gerontology Nurse Practitioner · NPI 1972075356

Vicki Sue Revak, MSN, AGAC-BC is a Nurse Practitioner in Horsham, Pennsylvania. Qualified in 2018, 8 years ago. Practices with University Hospitals Medical Group Inc, a 2,242-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
8
Licensed in
PA
In the registry since
2018
What do these letters mean?
MSN — Master of Science in Nursing
A graduate nursing degree, usually held alongside an advanced practice licence.

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Practice location Address checks out

680 Blair Mill Rd
Horsham, PA 19044-2223
Phone: (267) 261-4413
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence SP019667 (PA)

Record details

NPI number1972075356
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSN , AGAC-BC
Sole proprietorNo
NPI enumeratedDecember 22, 2018
Last updated in NPPESJune 24, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice University Hospitals Medical Group Inc — 2242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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