MEDICARE: MS. RITA T. WERMERS 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	148807	WI
2	363L00000X	Nurse Practitioner	R 194212-5	MN
3	363LA2200X	Adult Health Nurse Practitioner	AP5054	AZ

General Provider Information

NPI Number	:	1841480548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RITA T. WERMERS N.P.

Provider Business Mailing Address
First Line	:	500 N 3RD ST
Second Line	:	SUITE 155
City	:	PHOENIX
State	:	AZ
Zip	:	85004-2135
Country	:	US
Telephone Number	:	602-496-0721
Fax Number	:	602-496-0675

Provider Business Practice Location Address
First Line	:	500 N 3RD ST
Second Line	:	SUITE 155
City	:	PHOENIX
State	:	AZ
Zip	:	85004-2135
Country	:	US
Telephone Number	:	602-496-0721
Fax Number	:	602-496-0675

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

Provider Enumeration Date	:	07/28/2007
Last Update Date	:	06/26/2013

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