MEDICARE: FRANCIS IRENE SUTTON RN

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	163WH0200X	Home Health Registered Nurse	583584	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	583584	OTHER	TX	TEXAS BON

General Provider Information

NPI Number	:	1639658610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCIS IRENE SUTTON RN

Provider Business Mailing Address
First Line	:	2132 FALCON VILLAGE LN APT 13103
Second Line	:
City	:	PFLUGERVILLE
State	:	TX
Zip	:	78660-4725
Country	:	US
Telephone Number	:	512-460-9855
Fax Number	:

Provider Business Practice Location Address
First Line	:	6934 E BEN WHITE BLVD APT 11108
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78741-0040
Country	:	US
Telephone Number	:	512-460-9855
Fax Number	:

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

Provider Enumeration Date	:	08/09/2018
Last Update Date	:	08/09/2018

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