MEDICARE: JENNIFER A RAMIN ANP

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	363LA2200X	Adult Health Nurse Practitioner	RN123354	AZ

General Provider Information

NPI Number	:	1588645204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER A RAMIN ANP

Provider Business Mailing Address
First Line	:	1775 E SKYLINE DR
Second Line	:	STE 101
City	:	TUCSON
State	:	AZ
Zip	:	85718-1162
Country	:	US
Telephone Number	:	520-615-6200
Fax Number	:	520-615-6255

Provider Business Practice Location Address
First Line	:	1775 E SKYLINE DR
Second Line	:	STE 101
City	:	TUCSON
State	:	AZ
Zip	:	85718-1162
Country	:	US
Telephone Number	:	520-615-6200
Fax Number	:	520-615-6255

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	07/08/2007

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