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NPI Code Detail

MEDICARE: MRS. RUTH LIMARIS VAZQUEZ FNP-BC

MEDICARE: MRS. RUTH LIMARIS VAZQUEZ FNP-BC
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
1163W00000XRegistered Nurse128750TN
2363LF0000XFamily Nurse Practitioner14583TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1128750OTHERTNRN

General Provider Information

NPI Number : 1205059839
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RUTH LIMARIS VAZQUEZ FNP-BC
Provider Business Mailing Address
First Line : 881 PROFESSIONAL PARK DR
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37040-5257
Country : US
Telephone Number : 931-645-4685
Fax Number : 931-245-2117
Provider Business Practice Location Address
First Line : 881 PROFESSIONAL PARK DR
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37040-5257
Country : US
Telephone Number : 931-645-4685
Fax Number : 931-245-2117
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 11/23/2011

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Directions to “ MRS. RUTH LIMARIS VAZQUEZ FNP-BC” Practice Location

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