MEDICARE: ALLISON TUBBS MSN, ARNP, 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
1	363LF0000X	Family Nurse Practitioner	ARNP3069992	FL

General Provider Information

NPI Number	:	1407296668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON TUBBS MSN, ARNP, FNP-BC

Provider Business Mailing Address
First Line	:	13691 METRO PKWY STE 310
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-4322
Country	:	US
Telephone Number	:	239-768-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	13691 METRO PKWY STE 310
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-4322
Country	:	US
Telephone Number	:	239-768-1400
Fax Number	:

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

Provider Enumeration Date	:	07/02/2013
Last Update Date	:	07/02/2013

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