MEDICARE: MS. MARY JEAN DUTHIE ARNP

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
1	363LP0200X	Pediatric Nurse Practitioner	ARNP 3126442	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3126442	OTHER	FL	LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578604427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY JEAN DUTHIE ARNP

Provider Business Mailing Address
First Line	:	2024 SW TRAILSIDE PATH
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-9013
Country	:	US
Telephone Number	:	772-545-3648
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 PROSPERITY FARMS RD STE F
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-5212
Country	:	US
Telephone Number	:	772-233-7303
Fax Number	:	772-233-7303

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	07/21/2022

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