MEDICARE: MRS. RUTH A. OBREZA 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	RN.289867	OH

General Provider Information

NPI Number	:	1780708396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RUTH A. OBREZA RN

Provider Business Mailing Address
First Line	:	5219 BERKSHIRE DR
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-3021
Country	:	US
Telephone Number	:	440-777-2311
Fax Number	:

Provider Business Practice Location Address
First Line	:	5219 BERKSHIRE DR
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-3021
Country	:	US
Telephone Number	:	440-777-2311
Fax Number	:

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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