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NPI Code Detail

MEDICARE: MRS. RITA TESTA RAGAN FNP-BC

MEDICARE: MRS. RITA TESTA RAGAN FNP-BC
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
1363LF0000XFamily Nurse PractitionerARNP9405872FL

General Provider Information

NPI Number : 1255584173
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RITA TESTA RAGAN FNP-BC
Provider Business Mailing Address
First Line : 105 SOUTHPARK BLVD C300
Second Line :
City : SAINT AUGUSTINE
State : FL
Zip : 32086-4162
Country : US
Telephone Number : 904-808-7246
Fax Number : 904-808-7090
Provider Business Practice Location Address
First Line : 2089 SOUTHRIDGE DR
Second Line :
City : TUPELO
State : MS
Zip : 38801-6478
Country : US
Telephone Number : 662-407-0801
Fax Number : 662-821-0422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2008
Last Update Date : 08/25/2015

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Directions to “ MRS. RITA TESTA RAGAN FNP-BC” Practice Location

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