MEDICARE: RUTH ANN BAFFA-WATERS

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	RN9504422	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11032122	FL

General Provider Information

NPI Number	:	1225880024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH ANN BAFFA-WATERS

Provider Business Mailing Address
First Line	:	2617 W HORATIO ST APT B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4157
Country	:	US
Telephone Number	:	610-246-6765
Fax Number	:

Provider Business Practice Location Address
First Line	:	2617 W HORATIO ST APT B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4157
Country	:	US
Telephone Number	:	610-246-6765
Fax Number	:

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

Provider Enumeration Date	:	04/04/2024
Last Update Date	:	04/04/2024

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Directions to “ RUTH ANN BAFFA-WATERS ” Practice Location

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