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General NPI Number Information
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NPI Number | 1962450932
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Entity Type | Individual
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Provider Name | COLLEEN ELIZABETH SCUDDER ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 04/15/2009
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Provider Practice Location Address
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Address Line | 2776 CLEVELAND AVE
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City | FT MYERS
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State | FL
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Zip | 33901-5864
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Country | US
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Telephone | 239-334-5283
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 2147
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City | FT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-424-1400
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Fax | 234-424-1421
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | ARNP 9242980
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9242980
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License Number State | FL
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