MEDICARE: MRS. JANET ELIZABETH KOHARIK 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	ARNP 1629122	FL
2	363LF0000X	Family Nurse Practitioner	AP3752	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497742480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANET ELIZABETH KOHARIK FNP-BC

Provider Business Mailing Address
First Line	:	9525 E OLD SPANISH TRL
Second Line	:	SUITE 101
City	:	TUCSON
State	:	AZ
Zip	:	85748-6631
Country	:	US
Telephone Number	:	520-647-1319
Fax Number	:	520-721-9798

Provider Business Practice Location Address
First Line	:	9525 E OLD SPANISH TRL
Second Line	:	SUITE 101
City	:	TUCSON
State	:	AZ
Zip	:	85748-6631
Country	:	US
Telephone Number	:	520-647-1319
Fax Number	:	520-721-9798

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	12/27/2012

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