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General NPI Number Information
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NPI Number | 1033398821
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Entity Type | Individual
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Provider Name | TIMOTHY M REED FNP
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Gender | Male
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 10/29/2007
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Provider Practice Location Address
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Address Line | 20 HOSPITAL DR
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City | LOGAN
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State | WV
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Zip | 25601-3452
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Country | US
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Telephone | 304-831-1188
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Fax |
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Provider Business Mailing Address
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Address Line | 1431 CENTERPOINT BLVD SUITE 100
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City | KNOXVILLE
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State | TN
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Zip | 37932-1984
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Country | US
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Telephone |
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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 | 56642
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License Number State | WV
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