MEDICARE: ROBERT E FIRE NP

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	11420	CA

General Provider Information

NPI Number	:	1861771594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT E FIRE NP

Provider Business Mailing Address
First Line	:	54 EAST LOOP
Second Line	:
City	:	MADERA
State	:	CA
Zip	:	93637-4946
Country	:	US
Telephone Number	:	559-662-8818
Fax Number	:

Provider Business Practice Location Address
First Line	:	54 EAST LOOP
Second Line	:
City	:	MADERA
State	:	CA
Zip	:	93637-4946
Country	:	US
Telephone Number	:	559-662-8818
Fax Number	:

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

Provider Enumeration Date	:	08/11/2011
Last Update Date	:	08/11/2011

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Directions to “ ROBERT E FIRE NP” Practice Location

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