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NPI 1053586156

NPI 1053586156 : MRS. TIMREE LEE BROWN WILLIAMS : MARCELLUS, NY

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General NPI Number Information
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    NPI Number           |    1053586156
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    Entity Type          |    Individual 
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    Provider Name        |    MRS. TIMREE LEE BROWN WILLIAMS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/29/2008
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    Last Update Date     |    04/29/2008
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Provider Practice Location Address
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    Address Line         |    4415 LATHROP DR 
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    City                 |    MARCELLUS
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    State                |    NY
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    Zip                  |    13108-9737
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    Country              |    US
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    Telephone            |    315-730-5412
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4415 LATHROP DR 
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    City                 |    MARCELLUS
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    State                |    NY
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    Zip                  |    13108-9737
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    Country              |    US
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    Telephone            |    315-730-5412
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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        |    164W00000X
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    Taxonomy Name        |    Licensed Practical Nurse
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    License Number       |    292653
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    License Number State |    NY
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