MEDICARE: NHU ORTIZ FNP-C

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	363L00000X	Nurse Practitioner	SP025471	PA

General Provider Information

NPI Number	:	1093464521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NHU ORTIZ FNP-C

Provider Business Mailing Address
First Line	:	732 MANATAWNY ST
Second Line	:
City	:	POTTSTOWN
State	:	PA
Zip	:	19464-5143
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 MADISON AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43604-1516
Country	:	US
Telephone Number	:	567-585-9600
Fax Number	:

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

Provider Enumeration Date	:	03/22/2022
Last Update Date	:	03/22/2022

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