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NPI Code Detail

MEDICARE: MRS. BIBI S KOO APRN

MEDICARE: MRS. BIBI S KOO APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerARNP3183022FL
2363LA2200XAdult Health Nurse PractitionerARNP3183022FL
3363LA2100XAcute Care Nurse PractitionerARNP3183022FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083857809
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BIBI S KOO APRN
Provider Business Mailing Address
First Line : PO BOX 906
Second Line :
City : RUSKIN
State : FL
Zip : 33575-0906
Country : US
Telephone Number : 727-744-7995
Fax Number :
Provider Business Practice Location Address
First Line : 6240 N DURANGO DR STE 120
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-3941
Country : US
Telephone Number : 954-923-7440
Fax Number : 844-209-2827
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2009
Last Update Date : 08/24/2022

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Directions to “ MRS. BIBI S KOO APRN” Practice Location

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