MEDICARE: JOHN R ARMBRUSTER FNP

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	363LF0000X	Family Nurse Practitioner	2015001137	MO

General Provider Information

NPI Number	:	1003207242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN R ARMBRUSTER FNP

Provider Business Mailing Address
First Line	:	612 HWY 25 SOUTH
Second Line	:
City	:	BLOOMFIELD
State	:	MO
Zip	:	63825-9566
Country	:	US
Telephone Number	:	573-568-7377
Fax Number	:	573-568-7320

Provider Business Practice Location Address
First Line	:	612 STATE HIGHWAY 25 S
Second Line	:
City	:	BLOOMFIELD
State	:	MO
Zip	:	63825-9566
Country	:	US
Telephone Number	:	573-803-3995
Fax Number	:	573-803-5222

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

Provider Enumeration Date	:	02/10/2015
Last Update Date	:	08/08/2023

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