Healthcare Provider Details

I. General information

NPI: 1508968942
Provider Name (Legal Business Name): ELIZABETH TRUEB ROSCHER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH ANN TRUEB ARNP

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 09/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 9TH STREET DR W
PALMETTO FL
34221-4802
US

IV. Provider business mailing address

218 9TH STREET DR W
PALMETTO FL
34221-4802
US

V. Phone/Fax

Practice location:
  • Phone: 941-721-3900
  • Fax: 941-721-7403
Mailing address:
  • Phone: 941-721-3900
  • Fax: 941-721-7403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberFLORIDA ARNP 1788802
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: