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NPI Code Detail

MEDICARE: MRS. SHARON TUTLEWSKI FNP

MEDICARE: MRS. SHARON TUTLEWSKI 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
1363LF0000XFamily Nurse Practitioner71000150IN

Other Identifiers

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

General Provider Information

NPI Number : 1558475855
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHARON TUTLEWSKI FNP
Provider Business Mailing Address
First Line : 2490 CENTRAL AVE
Second Line :
City : LAKE STATION
State : IN
Zip : 46405-2122
Country : US
Telephone Number : 219-962-2760
Fax Number : 219-962-1757
Provider Business Practice Location Address
First Line : 2490 CENTRAL AVE
Second Line :
City : LAKE STATION
State : IN
Zip : 46405-2122
Country : US
Telephone Number : 219-962-2760
Fax Number : 219-962-1757
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 11/29/2011

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Directions to “ MRS. SHARON TUTLEWSKI FNP” Practice Location

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