MEDICARE: MS. ANN MARIE PAPCZYNSKI FNP

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	28112092A	IN
2	363LF0000X	Family Nurse Practitioner	71003169A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	71003169A	OTHER	IN	PRESCRIPTION AUTHORITY

General Provider Information

NPI Number	:	1326378688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANN MARIE PAPCZYNSKI FNP

Provider Business Mailing Address
First Line	:	1901 #B WESTERN AVE
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46619
Country	:	US
Telephone Number	:	574-234-9033
Fax Number	:

Provider Business Practice Location Address
First Line	:	1901B W WESTERN AVE
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46619-3521
Country	:	US
Telephone Number	:	574-234-9033
Fax Number	:

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

Provider Enumeration Date	:	01/10/2010
Last Update Date	:	01/22/2010

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