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NPI Code Detail

MEDICARE: MS. JEANNETTE MCCAIN MS,ARNP-C

MEDICARE: MS. JEANNETTE MCCAIN MS,ARNP-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
1363LA2200XAdult Health Nurse PractitionerARNP938642FL

General Provider Information

NPI Number : 1174515126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JEANNETTE MCCAIN MS,ARNP-C
Provider Business Mailing Address
First Line : 22613 WILLOW LAKES DR
Second Line :
City : LUTZ
State : FL
Zip : 33549-8735
Country : US
Telephone Number : 813-972-7661
Fax Number : 813-978-5893
Provider Business Practice Location Address
First Line : 13000 BRUCE B DOWNS BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33612-4745
Country : US
Telephone Number : 813-972-7661
Fax Number : 813-972-5893
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 07/26/2007

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