MEDICARE: MS. JOANNA D SIKKEMA ARNP

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	363LA2200X	Adult Health Nurse Practitioner	61776-2	FL

General Provider Information

NPI Number	:	1861511198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOANNA D SIKKEMA ARNP

Provider Business Mailing Address
First Line	:	8820 SW 162ND ST
Second Line	:
City	:	VILLAGE OF PALMETTO BAY
State	:	FL
Zip	:	33157-3515
Country	:	US
Telephone Number	:	305-253-0811
Fax Number	:	305-253-0811

Provider Business Practice Location Address
First Line	:	9250 W FLAGLER ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-3414
Country	:	US
Telephone Number	:	305-552-2342
Fax Number	:	305-552-2099

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

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	07/08/2007

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