MEDICARE: BARBARA TRUITT R.N.

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	163WI0500X	Infusion Therapy Registered Nurse	RN235708L	PA

General Provider Information

NPI Number	:	1063660637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA TRUITT R.N.

Provider Business Mailing Address
First Line	:	1190 FISHING CREEK RD
Second Line	:
City	:	ROULETTE
State	:	PA
Zip	:	16746-1814
Country	:	US
Telephone Number	:	814-544-7302
Fax Number	:

Provider Business Practice Location Address
First Line	:	1190 FISHING CREEK RD
Second Line	:
City	:	ROULETTE
State	:	PA
Zip	:	16746-1814
Country	:	US
Telephone Number	:	814-544-7302
Fax Number	:

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

Provider Enumeration Date	:	09/08/2008
Last Update Date	:	09/08/2008

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