MEDICARE: GAIL LEE RATHBUN ARNP

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	ARNP9275512	FL

General Provider Information

NPI Number	:	1164792602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL LEE RATHBUN ARNP

Provider Business Mailing Address
First Line	:	6311 S. POINTE BLVD
Second Line	:
City	:	FORT MEYERS
State	:	FL
Zip	:	33919
Country	:	US
Telephone Number	:	239-275-0040
Fax Number	:	239-275-7997

Provider Business Practice Location Address
First Line	:	6311 S. POINTE BLVD.
Second Line	:
City	:	FORT MEYERS
State	:	FL
Zip	:	33919
Country	:	US
Telephone Number	:	239-275-0040
Fax Number	:	239-275-7997

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

Provider Enumeration Date	:	12/30/2011
Last Update Date	:	12/30/2011

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