MEDICARE: MS. RUTH ANN ZISSER WHNP

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	363LW0102X	Women's Health Nurse Practitioner	APN.0000296-NP	CO
2	363LW0102X	Women's Health Nurse Practitioner	11008926	FL

General Provider Information

NPI Number	:	1245397595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RUTH ANN ZISSER WHNP

Provider Business Mailing Address
First Line	:	5410 ANTIGUA CIR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-7605
Country	:	US
Telephone Number	:	303-885-7240
Fax Number	:

Provider Business Practice Location Address
First Line	:	5410 ANTIGUA CIR
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-7605
Country	:	US
Telephone Number	:	303-885-7240
Fax Number	:

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

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	10/06/2020

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