MEDICARE: RUTH MARIE BISHR MS ARNP C

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	2812452	FL

General Provider Information

NPI Number	:	1750475026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH MARIE BISHR MS ARNP C

Provider Business Mailing Address
First Line	:	1001 ORIOLE CIRCLE
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34105
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2685 HORSESHOE DRIVE SOUTH
Second Line	:	SUITE 101 VA PRIMARY CARE CLINIC
City	:	NAPLES
State	:	FL
Zip	:	34104
Country	:	US
Telephone Number	:	239-659-9188
Fax Number	:	239-659-0526

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2007

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