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General NPI Number Information
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NPI Number | 1013170653
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Entity Type | Individual
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Provider Name | WILLIAM WENSTROM ACNP
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Gender | Male
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 4300 HOSPITAL ST STE 102
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City | PASCAGOULA
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State | MS
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Zip | 39581-5308
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Country | US
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Telephone | 228-809-5110
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Fax | 228-372-8271
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Provider Business Mailing Address
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Address Line | 2101 HIGHWAY 90
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City | GAUTIER
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State | MS
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Zip | 39553-5340
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Country | US
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Telephone | 228-497-7576
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Fax | 228-497-8869
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 851481
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License Number State | MS
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