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General NPI Number Information
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NPI Number | 1508825407
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Entity Type | Individual
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Provider Name | JEANNE RYAN BOTZ ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 10/07/2022
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Provider Practice Location Address
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Address Line | 33920 US HIGHWAY 19 N STE 107
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City | PALM HARBOR
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State | FL
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Zip | 34684-2654
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Country | US
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Telephone | 727-781-1000
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Fax | 727-330-7551
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Provider Business Mailing Address
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Address Line | 8002 KING HELIE BLVD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653-1435
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Country | US
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Telephone | 727-841-4200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1630102
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License Number State | FL
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