MEDICARE: SHAWN PEART RAMIREZ RN

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	163WS0200X	School Registered Nurse	631681	AZ

General Provider Information

NPI Number	:	1538362546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN PEART RAMIREZ RN

Provider Business Mailing Address
First Line	:	15296 N. 62ND DR.
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306
Country	:	US
Telephone Number	:	602-938-6997
Fax Number	:

Provider Business Practice Location Address
First Line	:	6602 W OSBORN RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85033-4533
Country	:	US
Telephone Number	:	623-691-4615
Fax Number	:

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

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	07/08/2007

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