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General NPI Number Information
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NPI Number | 1003307596
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Entity Type | Individual
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Provider Name | MARIE C VICTOR
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Gender | Female
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 04/16/2020
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Provider Practice Location Address
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Address Line | 2 HOSPITAL DR STE 101
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City | HOLYOKE
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State | MA
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Zip | 01040-6616
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Country | US
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Telephone | 413-536-8924
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Fax |
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Provider Business Mailing Address
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Address Line | 2823 SW 82ND AVE
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City | MIRAMAR
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State | FL
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Zip | 33025-7404
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Country | US
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Telephone | 954-638-0324
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9267015
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2337712
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License Number State | MA
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