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General NPI Number Information
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NPI Number | 1013613942
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Entity Type | Individual
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Provider Name | JOSHUA L. CARMACK APN
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Gender | Male
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Dates
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Enumeration Date | 02/02/2023
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 350 DAWSON ST
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City | VONORE
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State | TN
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Zip | 37885-2420
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Country | US
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Telephone | 731-203-0062
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Fax | 865-321-1822
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Provider Business Mailing Address
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Address Line | 668 KARCH DR
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City | MARYVILLE
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State | TN
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Zip | 37803-6258
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Country | US
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Telephone | 901-651-7116
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Fax | 865-321-1822
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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 | 33287
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License Number State | TN
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