MEDICARE: JOHANNA CURTIS NP-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	163W00000X	Registered Nurse	1-103344	AL
2	363LF0000X	Family Nurse Practitioner	1-103344	AL

General Provider Information

NPI Number	:	1114258456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHANNA CURTIS NP-C

Provider Business Mailing Address
First Line	:	PO BOX 37215
Second Line	:
City	:	BALITMORE
State	:	MD
Zip	:	21297-7215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1304 13TH AVE SE STE B
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-4316
Country	:	US
Telephone Number	:	256-355-1843
Fax Number	:

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

Provider Enumeration Date	:	01/27/2010
Last Update Date	:	08/10/2021

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