MEDICARE: RACHELLE FIUZA

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	363LG0600X	Gerontology Nurse Practitioner	AG10230033	OH
2	363LP2300X	Primary Care Nurse Practitioner	AG10230033	OH
3	363LA2200X	Adult Health Nurse Practitioner	AG10230033	OH

General Provider Information

NPI Number	:	1639936891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHELLE FIUZA

Provider Business Mailing Address
First Line	:	1792 WILENE DR
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45432-4017
Country	:	US
Telephone Number	:	941-201-8178
Fax Number	:

Provider Business Practice Location Address
First Line	:	4201 INTERWAY PL
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-5668
Country	:	US
Telephone Number	:	817-735-1180
Fax Number	:

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

Provider Enumeration Date	:	03/04/2024
Last Update Date	:	04/16/2025

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Directions to “ RACHELLE FIUZA ” Practice Location

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