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NPI Code Detail

MEDICARE: MRS. MARY ANN FOOTE RN MSN CANP CWCN ED.

MEDICARE: MRS. MARY ANN FOOTE RN MSN CANP CWCN ED.
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
1363LA2200XAdult Health Nurse Practitioner041164265IL
2364SG0600XGerontology Clinical Nurse Specialist209-003106IL

General Provider Information

NPI Number : 1548265325
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY ANN FOOTE RN MSN CANP CWCN ED.
Provider Business Mailing Address
First Line : 608 S WASHINGTON ST
Second Line :
City : NAPERVILLE
State : IL
Zip : 60540-6663
Country : US
Telephone Number : 630-898-3360
Fax Number : 630-898-3358
Provider Business Practice Location Address
First Line : 608 S WASHINGTON ST
Second Line :
City : NAPERVILLE
State : IL
Zip : 60540-6663
Country : US
Telephone Number : 630-898-3360
Fax Number : 630-898-3358
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 12/04/2009

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