MEDICARE: MRS. ANN TERESA EICHNER RN, CRRN, CCM, QRP

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	163W00000X	Registered Nurse	557092	FL

General Provider Information

NPI Number	:	1902195944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANN TERESA EICHNER RN, CRRN, CCM, QRP

Provider Business Mailing Address
First Line	:	458 OAK HAVEN DRIVE
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701
Country	:	US
Telephone Number	:	407-964-1602
Fax Number	:	407-964-1170

Provider Business Practice Location Address
First Line	:	458 OAK HAVEN DR
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-6318
Country	:	US
Telephone Number	:	407-964-1602
Fax Number	:	407-964-1170

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

Provider Enumeration Date	:	03/30/2011
Last Update Date	:	03/30/2011

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