MEDICARE: JOANN IRVING A.R.N.P.

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	363L00000X	Nurse Practitioner	ARNP9216693	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y084R	OTHER	FL	FL BC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821041716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANN IRVING A.R.N.P.

Provider Business Mailing Address
First Line	:	2675 WINKLER AVE
Second Line	:	FL 2
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9342
Country	:	US
Telephone Number	:	877-856-3774
Fax Number	:	239-599-2625

Provider Business Practice Location Address
First Line	:	13823 TAMIAMI TRL
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34287-2069
Country	:	US
Telephone Number	:	941-888-0770
Fax Number	:	941-888-0778

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	08/26/2020

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